Individual
JOHN DOUGLAS WATHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN, MSN, PMHNP
Contact information
Practice address
415 MULBERRY ST, EVANSVILLE, IN 47713-1230
(812) 423-7791
Mailing address
5566 WHITEGATE CT, NEWBURGH, IN 47630-8274
(812) 589-9350
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
28209048A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
71010207A
IN
Other
Enumeration date
06/14/2020
Last updated
10/02/2020
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