Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Pain Clinic MOB5
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4133 GATEWAY BLVD STE 290, NEWBURGH, IN 47630-7918
(812) 450-7246
(812) 450-4855
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-7246
(812) 450-4855
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
09/17/2018
Last updated
07/12/2019
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