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Organization

DEACONESS CLINIC, INC

Active
Other names
Deaconess Clinic I
Organization subpart
No

Provider details

NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization

Contact information

Practice address
3150 WARRICK DR, BOONVILLE, IN 47601-8602
(812) 858-3355
(812) 858-3350
Mailing address
PO BOX 1510, EVANSVILLE, IN 47706-1510
(812) 450-6879
(812) 858-4586

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
207R00000X
Internal Medicine Physician
208000000X
Pediatrics Physician
363A00000X
Physician Assistant
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner

Other

Enumeration date
08/12/2013
Last updated
10/27/2020
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