Organization
DEACONESS CLINIC, INC
Active
Other names
Deaconess Clinic - Gibson Hospital Suite 2204
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
1808 SHERMAN DR, PRINCETON, IN 47670-1043
(812) 386-7522
(812) 386-1097
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 386-7522
(812) 386-1097
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
261QR1300X
Rural Health Clinic/Center
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Enumeration date
08/18/2020
Last updated
12/07/2023
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