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Organization
DEACONESS CLINIC, INC
Active
Organization
DEACONESS CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
1025 1ST AVE W, JASPER, IN 47546-3217
(812) 559-3000
(812) 559-3001
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
(812) 450-6815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/28/2025
Last updated
07/28/2025
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