| Doctor Name: | MS. DIANE A SMITH |
| NPI Number: | 1205891264 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN, CRNP |
| License Number: | TP001045H |
| Business Practice Address: | 123 Ridgefield Rd Newtown Square, PA - 190733812 |
| Business Phone Number: | 6103532152 |
| Business Fax Number: | 6103562730 |
| Mailing Address: | 123 Ridgefield Rd, NEWTOWN SQUARE |
| State: | PA |
| Postal Code: | 190733812 |
| Phone Number: | 6103532152 |
| Fax Number: | 6103562730 |
| NPI Enumeration Date: | 04/20/2006 |
| NPI Last Update Date: | 01/08/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LG0600X |
| License Number: | TP001045H |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Gerontology |
| Taxonomy Definition: | |