Individual
MS. DIANNE TERRELL SMITH I
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1701 HARDEE AVE. S W, FORT MCPHERSON, GA 30330
(404) 464-0400
(404) 464-0415
Mailing address
115 FAIRWAY TRL, COVINGTON, GA 30014-3973
(404) 464-0400
(404) 464-0415
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
RN 045158
GA
Other
Enumeration date
06/07/2007
Last updated
07/08/2007
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