Organization
DEACONESS CLINIC, INC.
Active
Organization
DEACONESS CLINIC, INC.
Active
Other names
Deaconess Clinic - Memorial
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
645 CONNIE ROBINSON WAY, EVANSVILLE, IN 47713-1822
(812) 450-8764
(124) 012-1178
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261Q00000X
Clinic/Center
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
11/12/2020
Last updated
04/07/2021
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