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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
721 W 13TH ST, JASPER, IN 47546-1855
(812) 996-7918
(812) 996-1644
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-2767
(812) 450-6879

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
05/16/2025
Last updated
05/16/2025
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