# 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 Derm Henderson
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275289621
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 1305 N ELM ST, HENDERSON, KY 42420-2783
- **Practice address phone:** (270) 215-3154
- **Practice address fax:** (812) 450-0080
- **Mailing address:** PO BOX 631767, CINCINNATI, OH 45263-1767
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 02/24/2022
- **Last updated:** 09/14/2026