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
2851 NEW HARTFORD RD, OWENSBORO, KY 42303-1320
(812) 479-3153
(812) 858-4546
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-1767
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/25/2023
Last updated
05/25/2023
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