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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
5230 E DIVISION ST, EVANSVILLE, IN 47715-3224
(812) 490-1140
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/02/2023
Last updated
03/02/2023
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