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Individual

MRS. DIANA BEATRICE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNPC-C

Contact information

Practice address
804 KENYON RD, SUITE M, FORT DODGE, IA 50501-5742
(515) 574-6850
(515) 576-4510
Mailing address
802 KENYON RD, 513, FORT DODGE, IA 50501-5740
(515) 574-6890

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A-125675
IA

Other

Enumeration date
07/23/2012
Last updated
08/15/2013
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