Individual
DIANE RUTH SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
238 BROOKLEY AVE., BOLLING AFB, DC 20332-0001
(202) 404-3603
Mailing address
1016 S WAYNE ST, #612, ARLINGTON, VA 22204-4433
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
0001040494
VA
Other
Enumeration date
01/06/2006
Last updated
07/08/2007
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