Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
415 W COLUMBIA ST, STE 100, EVANSVILLE, IN 47710-1656
(812) 450-6200
(812) 450-6202
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-6200
(812) 450-6202
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
363L00000X
Nurse Practitioner
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100241900
—
IN
Enumeration date
07/10/2008
Last updated
08/21/2017
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