Organization
DEACONESS HOSPITAL INC
Active
Other names
Deaconess Pulmonary Critical Care - Gateway
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4015 GATEWAY BLVD, STE 2121, NEWBURGH, IN 47630-8925
(812) 450-7720
(812) 450-7730
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-7720
(812) 450-7730
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RP1001X
Pulmonary Disease Physician
Primary
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100253870B
—
IN
Enumeration date
05/27/2006
Last updated
07/06/2017
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