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Organization

DEACONESS HOSPITAL, INC

Active
Other names
Deaconess Pain Clinic Gateway
Organization subpart
No

Provider details

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

Contact information

Practice address
4015 GATEWAY BLVD STE 2120, NEWBURGH, IN 47630-9460
(812) 842-2737
(812) 842-2751
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 842-2737
(812) 842-2751

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
208VP0000X
Pain Medicine Physician
Primary
363L00000X
Nurse Practitioner
363LF0000X
Family Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200226410G
IN
Enumeration date
08/11/2010
Last updated
02/13/2024
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