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Organization
DEACONESS HOSPITAL, INC
Active
Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Pain Clinic MOB5
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4133 GATEWAY BLVD STE 290, NEWBURGH, IN 47630-7918
(812) 450-7246
(812) 450-4855
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-7246
(812) 450-4855
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/17/2018
Last updated
07/12/2019
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