Organization
DEACONESS CLINIC INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4011 GATEWAY BLVD, NEWBURGH, IN 47630-8947
(812) 490-4570
(812) 490-4570
Mailing address
PO BOX 1510, NEWBURGH, IN 47629-1510
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RN0300X
Nephrology Physician
—
—
2084N0400X
Neurology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/02/2019
Last updated
10/04/2022
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