# DEACONESS CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Deaconess Clinic - Dixon
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184243370
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 1335 US HIGHWAY 41A S, DIXON, KY 42409-9447
- **Practice address phone:** (270) 639-9101
- **Practice address fax:** (270) 639-9332
- **Mailing address:** PO BOX 1510, EVANSVILLE, IN 47706-1510
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 04/09/2020
- **Last updated:** 04/09/2020