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
115 S MAIN ST, FERDINAND, IN 47532-9534
(812) 367-1906
(812) 367-2487
Mailing address
PO BOX 631767, CINCINNATI, OH 45263-2767
(812) 450-6879
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
05/16/2025
Last updated
05/16/2025
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