# DEACONESS CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013890250
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 1025 1ST AVE W, JASPER, IN 47546-3217
- **Practice address phone:** (812) 559-3000
- **Practice address fax:** (812) 559-3001
- **Mailing address:** PO BOX 631767, CINCINNATI, OH 45263-1767
- **Mailing address phone:** (812) 450-6815

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 07/28/2025
- **Last updated:** 07/28/2025