Individual
MRS. DIANE PATRICIA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
205 S MAIN ST, SUITE B, LONGMONT, CO 80501-1716
(303) 772-6244
(303) 702-1623
Mailing address
205 S MAIN ST, SUITE B, LONGMONT, CO 80501-1716
(303) 772-6244
(303) 702-1623
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
179580
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42101069
—
CO
Enumeration date
02/15/2007
Last updated
02/20/2014
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