NPI | 1730579525 |
---|---|
Former Name | DIANE LYNN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: IN 71005606A) |
Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: IN 28124384A) |
Enumeration Date | 2015-01-31 |
Last Update Date | 2023-10-12 |