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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
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