Smith, Diana

Smith, Diana is an individual health care provider with primary practice located at 635 W Corona Ave Ste 200 , Pueblo CO 81004-1210. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Smith, Diana can be contacted via phone (719) 553-7521.

Contact Information

Primary practice address
635 W Corona Ave Ste 200 Pueblo CO 81004-1210
Phone: (719) 553-7521
Fax: (719) 229-4672
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Community Health 163WC1500X RN81430 Colorado
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X APN.0991239-NP Colorado
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 991239 Colorado

Profile Details

NPI number 1689948424
LBN Legal business name Smith, Diana
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2012
Last updated Dec 28th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689948424 NPPES
Colorado Other 1G4858 MEDICARE
Colorado MEDICAID 39278352 MEDICARE

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