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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
1414 W BROADWAY ST, PRINCETON, IN 47670-1142
(812) 385-9397
Mailing address
PO BOX 3366, EVANSVILLE, IN 47732-3366
(812) 450-7455
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
01/17/2024
Last updated
01/17/2024
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