Provider Demographics
NPI:1922230978
Name:VESTERLUND, MARTHA ADAIR NOLEN (APRN, FNP-C, ANP-C)
Entity Type:Individual
Prefix:DR
First Name:MARTHA
Middle Name:ADAIR NOLEN
Last Name:VESTERLUND
Suffix:
Gender:F
Credentials:APRN, FNP-C, ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:237 PATCHWORK DR
Mailing Address - Street 2:
Mailing Address - City:STEPHENSON
Mailing Address - State:VA
Mailing Address - Zip Code:22656-2067
Mailing Address - Country:US
Mailing Address - Phone:434-941-2739
Mailing Address - Fax:
Practice Address - Street 1:237 PATCHWORK DR
Practice Address - Street 2:
Practice Address - City:STEPHENSON
Practice Address - State:VA
Practice Address - Zip Code:22656-2067
Practice Address - Country:US
Practice Address - Phone:434-941-2739
Practice Address - Fax:877-940-3601
Is Sole Proprietor?:No
Enumeration Date:2009-08-10
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024-168415207RC0000X
VA0024168415363L00000X
VA00241688415363LP0808X
WV101901363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1922230978Medicaid