Organization
DEACONESS CLINIC, INC
Active
Other names
Deaconess Clinic Pediatrics Elm
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL ANNETTE WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
2000 N ELM ST, HENDERSON, KY 42420-2385
(270) 827-3573
(270) 827-1250
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6815
(812) 450-6822
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
—
—
Other
Enumeration date
04/10/2020
Last updated
06/05/2020
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