National Provider Identifier Database

PONY EXPRESS PEDIATRICS LLC
Pediatrics


Contact Information

PONY EXPRESS PEDIATRICS, LLC
1307 CROOK AVE
CHEYENNE, WY82001-5412
Phone: 321-313-3595
Fax:
Website:
Specialty Taxonomy Code
* Pediatrics 363LP0200X

* Indicates primary specialty

NPI Profile & details for PONY EXPRESS PEDIATRICS, LLC

NPI Number 1265087993
Legal business name
LBN
PONY EXPRESS PEDIATRICS, LLC
Authorized official CHRISTA KOVACHEVICH - (OWNER/APRN CPNP-PC)
Entity Organization
Organization subpart Yes
Enumeration date 08/08/2019
Last updated 08/08/2019 - About 7 years ago
Sole proprietor1 Not specified
Identifiers
  • FL Medicaid: 016218600

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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