# DEACONESS CLINIC, INC

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

## Provider details

- **NPI number:** 1528214400
- **Authorized official:** CHERYL A WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 685 VAIL STREET, PRINCETON, IN 47670-9510
- **Practice address phone:** (812) 386-6560
- **Practice address fax:** (812) 385-5015
- **Mailing address:** PO BOX 1510, EVANSVILLE, IN 47706-1510
- **Mailing address phone:** (812) 386-6560
- **Mailing address fax:** (812) 385-5015

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 207K00000X | Allergy & Immunology Physician | — | NULL | — |
| 207K00000X | Allergy & Immunology Physician | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 207RP1001X | Pulmonary Disease Physician | — | NULL | — |
| 207RP1001X | Pulmonary Disease Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 261QR1300X | Rural Health Clinic/Center | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/12/2008
- **Last updated:** 12/07/2023