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
4498 N 1ST AVE, EVANSVILLE, IN 47710-3622
(812) 436-7280
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
(812) 450-6815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207RI0200X
Infectious Disease Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
2080P0208X
Pediatric Infectious Diseases Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
12/18/2023
Last updated
04/09/2024
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