Organization
YOUR CORNER PEDIATRICS, LLC
Active
Organization
YOUR CORNER PEDIATRICS, LLC
Active
Other names
Your Corner Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN MCGOVERN NP (OWNER)
(317) 676-9943
Entity
Organization
Contact information
Practice address
819 E 64TH ST STE 103, INDIANAPOLIS, IN 46220-1657
(317) 676-9943
(317) 943-9892
Mailing address
819 E 64TH ST STE 103, INDIANAPOLIS, IN 46220-1657
(317) 676-9943
(317) 943-9892
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1265662076
NPI NUMBER
IN
01
—
1659923761
NPI NUMBER
IN
Enumeration date
11/16/2023
Last updated
11/16/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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