# DEACONESS HOSPITAL, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Deaconess Family Medicine Residency
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629097639
- **Authorized official:** CHERYL A WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 415 W COLUMBIA ST STE 110, EVANSVILLE, IN 47710-1656
- **Practice address phone:** (812) 450-3363
- **Practice address fax:** (812) 450-3071
- **Mailing address:** PO BOX 3407, EVANSVILLE, IN 47733-3407
- **Mailing address phone:** (812) 450-6815
- **Mailing address fax:** (812) 450-6822

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 103T00000X | Psychologist | — | NULL | — |
| 103T00000X | Psychologist | — | — | — |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207V00000X | Obstetrics & Gynecology Physician | — | NULL | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |
| 363LF0000X | Family Nurse Practitioner | — | NULL | — |
| 363LF0000X | Family Nurse Practitioner | — | — | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | — | — |

## Other

- **Enumeration date:** 07/19/2006
- **Last updated:** 07/21/2022