Organization
DEACONESS HOSPITAL, INC
Active
Other names
Deaconess Sleep Center - Main
Organization subpart
No
Provider details
NPI number
Authorized official
CHERYL A WATHEN (CFO)
(812) 450-3296
Entity
Organization
Contact information
Practice address
350 W COLUMBIA ST, STE 210, EVANSVILLE, IN 47710
(812) 450-3852
(812) 450-6747
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-3852
(812) 450-6747
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
363LA2100X
Acute Care Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200226410J
—
IN
Enumeration date
08/02/2013
Last updated
06/12/2019
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