Individual
MRS. DIANE FULPER SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
8580 MAGELLAN PKWY, RICHMOND, VA 23227-1149
(804) 627-5360
(804) 627-5370
Mailing address
2907 TIDAL DR, MIDLOTHIAN, VA 23112-4370
(804) 627-5360
(804) 627-5370
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0024070952
VA
Other
Enumeration date
02/21/2012
Last updated
02/21/2012
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