Organization
DEACONESS CLINIC INC
Active
Organization
DEACONESS CLINIC INC
Active
Other names
Deaconess Clinic - MOB 6
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4219 GATEWAY BLVD, NEWBURGH, IN 47630
(812) 426-9545
(812) 858-4512
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
—
—
207RG0100X
Gastroenterology Physician
Primary
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Enumeration date
12/08/2020
Last updated
11/07/2024
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