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Individual

DIANE C. SMOAK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, BC, OCN

Contact information

Practice address
225 CANDLER DR, SAVANNAH, GA 31405-6023
(912) 354-6187
Mailing address
5400 SUTLIVE ST, SAVANNAH, GA 31405-4721
(912) 354-6187
(912) 692-0701

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN060923
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003149227D
GA
01
RN060923
MEDICAL LICENSE
GA
Enumeration date
09/25/2006
Last updated
07/21/2022
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