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Individual

MRS. DIANE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP

Contact information

Practice address
10648 S REMBRANDT LN, SANDY, UT 84070-5224
(435) 313-3142
(801) 705-0118
Mailing address
1301 BERTHA HOWE AVE, SUITE 1, MESQUITE, NV 89027-7502
(702) 346-0800
(702) 346-0801

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
8775403-4405
UT
363LF0000X
Family Nurse Practitioner
APRN001916
NV

Other

Enumeration date
03/26/2015
Last updated
11/05/2024
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