Individual
MRS. DIANE CARMELLA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
BLDG. 19H, MEDICAL SERVICE, 111, AVENUE D, PERRY POINT, MD 21902
(410) 642-2411
(410) 642-1898
Mailing address
107 SPRING LAKE WAY, HAVRE DE GRACE, MD 21078-1616
(410) 939-5511
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RO37786
MD
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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