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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
26020 STATE ROAD 145, BRISTOW, IN 47515-8865
(812) 357-2099
(812) 357-2097
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-2767
(812) 450-6815
(812) 450-6822

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363L00000X
Nurse Practitioner

Other

Enumeration date
06/18/2025
Last updated
06/18/2025
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