P31 Life

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

P31 LIFE

Practice address

4591 E Highway 20 Ste 202
Niceville, FL 32578-8845

Phone

(850) 299-9943

Fax

(863) 594-1643

NPI assigned

Sep 16, 2021

Last updated

Jul 28, 2026By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dianne Kelly Smith, DNP, APRN, FPMHNP-BCNPI 1467919365

Title

Owner

Phone

(850) 299-9943

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dianne Kelly Smith, DNP, APRN

  • Psychiatric/Mental Health Nurse Practitioner
  • Niceville, FL
  • NPI 1467919365
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785196800000",
    "number": "1336819788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4516 E HIGHWAY 20 # 168",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325789755",
            "telephone_number": "850-299-9943",
            "fax_number": "863-594-1643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4591 E HIGHWAY 20 STE 202",
            "city": "NICEVILLE",
            "state": "FL",
            "postal_code": "325788845",
            "telephone_number": "850-299-9943",
            "fax_number": "863-594-1643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P31 LIFE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-16",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A",
        "authorized_official_last_name": "KELLY SMITH",
        "authorized_official_first_name": "DIANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-299-9943",
        "authorized_official_credential": "DNP, APRN, FPMHNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Niceville, FL
• Providers in Niceville, FL by specialty
• Psychiatric/Mental Health Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.