# DEACONESS CLINIC, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1376267799
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 813 E 4TH ST, MOUNT VERNON, IN 47620-2012
- **Practice address phone:** (812) 450-2772
- **Mailing address:** PO BOX 1510, EVANSVILLE, IN 47706-1510
- **Mailing address phone:** (812) 450-2772

## Taxonomy

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

## Other

- **Enumeration date:** 09/29/2022
- **Last updated:** 09/29/2022