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Organization
DEACONESS CLINIC, INC
Active
Organization
DEACONESS CLINIC, INC
Active
Other names
Deaconess Clinic Klutey Park
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
471 KLUTEY PARK PLAZA DR, HENDERSON, KY 42420-3347
(270) 830-6100
(270) 826-3089
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
NULL
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
NULL
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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