Smith, Diane Patricia

Smith, Diane Patricia is an individual health care provider with primary practice located at 205 S Main St Suite B, Longmont CO 80501-1716. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Smith, Diane Patricia can be contacted via phone (303) 772-6244.

Contact Information

Primary practice address
205 S Main St Suite B Longmont CO 80501-1716
Fax: (303) 702-1623
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 179580 Colorado

Profile Details

NPI number 1033252044
LBN Legal business name Smith, Diane Patricia
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2007
Last updated Feb 20th, 2014 - about 10 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 1033252044 NPPES
Colorado MEDICAID 42101069

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