Provider Demographics
NPI:1083318752
Name:SMITH, DIANNA (MSN, PMHNP-BC, ARNP)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1104 LOTTO LN
Mailing Address - Street 2:
Mailing Address - City:BELL BUCKLE
Mailing Address - State:TN
Mailing Address - Zip Code:37020-6086
Mailing Address - Country:US
Mailing Address - Phone:615-582-3313
Mailing Address - Fax:
Practice Address - Street 1:1104 LOTTO LN
Practice Address - Street 2:
Practice Address - City:BELL BUCKLE
Practice Address - State:TN
Practice Address - Zip Code:37020-6086
Practice Address - Country:US
Practice Address - Phone:615-582-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN33579363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health