Organization
DEACONESS CLINC INC
Active
Other names
DC at Work - Main Street
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
123 MAIN ST STE B101, EVANSVILLE, IN 47708-2400
(812) 450-2772
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
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/05/2021
Last updated
04/05/2021
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