Organization
DEACONESS CLINIC, INC.
Active
Organization
DEACONESS CLINIC, INC.
Active
Other names
Deaconess Clinic - Vineyard
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
3805 FAIRVIEW DR, OWENSBORO, KY 42303-2117
(270) 240-2305
(270) 240-2252
Mailing address
PO BOX 3366, EVANSVILLE, IN 47732-3366
(270) 240-2305
(270) 240-2252
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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