Individual
DIANE M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2720 STONE PARK BLVD, SIOUX CITY, IA 51104-3734
(712) 279-3290
(712) 233-8095
Mailing address
PO BOX 683, SIOUX CITY, IA 51102-0683
(712) 279-3290
(712) 233-8095
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
097805
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0123695
—
IA
05
—
0151944
—
IA
Enumeration date
05/03/2006
Last updated
02/25/2010
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