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Organization
DEACONESS CLINIC INC
Active
Organization
DEACONESS CLINIC INC
Active
Other names
Deaconess Clinic Derm Henderson
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
1305 N ELM ST, HENDERSON, KY 42420-2783
(270) 215-3154
(812) 450-0080
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
02/24/2022
Last updated
09/14/2026
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