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
2622 MENARDS DR, EVANSVILLE, IN 47715-8075
(812) 450-2622
(812) 471-2063
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
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
IN
Other
Enumeration date
09/09/2016
Last updated
10/26/2020
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