Organization
DEACONESS CLINIC INC
Active
Other names
Deaconess Clinic I
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
8600 UNIVERSITY BLVD, ROOM HP0091, EVANSVILLE, IN 47712-3534
(812) 465-1250
(812) 465-7170
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 465-1250
(812) 465-7170
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/15/2011
Last updated
08/10/2017
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