# P31 LIFE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336819788
- **Authorized official:** DIANNE KELLY SMITH DNP, APRN, FPMHNP-BC (OWNER)
- **Authorized official phone:** (850) 299-9943

## Contact information

- **Practice address:** 4591 E HIGHWAY 20 STE 202, NICEVILLE, FL 32578-8845
- **Practice address phone:** (850) 299-9943
- **Practice address fax:** (863) 594-1643
- **Mailing address:** 4516 E HIGHWAY 20 \# 168, NICEVILLE, FL 32578-9755
- **Mailing address phone:** (850) 299-9943
- **Mailing address fax:** (863) 594-1643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/16/2021
- **Last updated:** 07/28/2026