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Contact Information

DIANA SMITH PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER LLC
635 W CORONA AVE STE 205
PUEBLO, CO81004-1210
 Phone: 719-553-7521
 Fax: 719-299-4672
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Child & Adolescent Psychiatry

2084P0804X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for DIANA SMITH PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER LLC

NPI # 1588275929
LBN Legal business name DIANA SMITH PSYCHIATRIC MENTAL HEALTH NURSE PRACTITIONER LLC
Authorized official DIANA SMITH - (PROVIDER)
Entity Organization
Organization subpart 1 No
Enumeration date 08/10/2020
Last updated 11/20/2025 - About 7 months ago
Identifiers
CO Medicaid 39278352
CO Medicaid 9000189137
CO Other 1G4859 MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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