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Organization
DEACONESS CLINIC, INC.
Active
Organization
DEACONESS CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
1414 W BROADWAY ST, PRINCETON, IN 47670-1142
(812) 385-5283
(812) 385-5274
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
NULL
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
10/30/2014
Last updated
02/09/2024
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