Individual
KITRA CORDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1040 E 86TH ST STE 46H, INDIANAPOLIS, IN 46240-1857
(317) 669-2880
Mailing address
358 S EMERSON AVE, INDIANAPOLIS, IN 46219-6933
(765) 993-4040
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
28178664A
IN
163WH0200X
Home Health Registered Nurse
28178664A
IN
163WW0000X
Wound Care Registered Nurse
28178664A
IN
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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