| Doctor Name: | MRS. DIANE PATRICIA SMITH |
| NPI Number: | 1033252044 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NURSE PRACTITIONER |
| License Number: | 179580 |
| Business Practice Address: | 205 S Main St Suite B Longmont, CO - 805011716 |
| Business Phone Number: | 3037726244 |
| Business Fax Number: | 3037021623 |
| Mailing Address: | 205 S Main St, Suite B LONGMONT |
| State: | CO |
| Postal Code: | 805011716 |
| Phone Number: | 3037726244 |
| Fax Number: | 3037021623 |
| NPI Enumeration Date: | 02/15/2007 |
| NPI Last Update Date: | 02/20/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 179580 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |