# DEACONESS CLINIC INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Deaconess Clinic - Comp Center Henderson
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679118582
- **Authorized official:** CHERYL ANNETTE WATHEN (CFO)
- **Authorized official phone:** (812) 450-3296

## Contact information

- **Practice address:** 2242 US HIGHWAY 41 N, HENDERSON, KY 42420-2375
- **Practice address phone:** (270) 844-8515
- **Practice address fax:** (270) 844-8183
- **Mailing address:** 329 W COLUMBIA ST, EVANSVILLE, IN 47710-1757
- **Mailing address phone:** (812) 450-7455
- **Mailing address fax:** (812) 450-2960

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 2083X0100X | Occupational Medicine Physician | — | NULL | — |
| 2083X0100X | Occupational Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 11/14/2019
- **Last updated:** 11/14/2019