# DEACONESS CLINIC, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1205078722
- **Authorized official:** CHERYL A WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 310 W IOWA ST, EVANSVILLE, IN 47710-1724
- **Practice address phone:** (812) 450-7419
- **Practice address fax:** (812) 450-6760
- **Mailing address:** PO BOX 1510, EVANSVILLE, IN 47706-1510
- **Mailing address phone:** (812) 450-7419
- **Mailing address fax:** (812) 450-6760

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | NULL | — |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 03/30/2009
- **Last updated:** 03/25/2022