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Organization
DEACONESS HOSPITAL, INC
Active
Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Pain Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4600 W LLOYD EXPY, EVANSVILLE, IN 47712-6517
(812) 450-7246
(812) 450-4855
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-4800
(812) 450-4855
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200226410H
—
IN
Enumeration date
08/11/2010
Last updated
07/28/2022
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