| Doctor Name: | DIANE RUTH SMITH |
| NPI Number: | 1073591285 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 0001040494 |
| Business Practice Address: | 238 Brookley Ave. Bolling Afb, DC - 203320001 |
| Business Phone Number: | 2024043603 |
| Business Fax Number: | |
| Mailing Address: | 1016 S Wayne St, #612 ARLINGTON |
| State: | VA |
| Postal Code: | 222044433 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 01/06/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 0001040494 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | VA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |