Organization
DEACONESS CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
4551 SPRINGHILL DR, OWENSBORO, KY 42303-4671
(270) 215-3199
(812) 450-6815
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207RG0100X
Gastroenterology Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/14/2019
Last updated
08/15/2024
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