Deaconess Clinic, INC

NPI #1104445014 in Henderson, Kentucky

Provider Information

NPI Number: 1104445014
Entity Type: Organization
Organization Name: Deaconess Clinic, INC
Primary Specialty: Family Medicine
Enumeration Date: Apr 10, 2020
Last Updated: Apr 10, 2020

Practice Location

Address: 471 KLUTEY PARK PLAZA DR
City: Henderson
State: Kentucky
ZIP Code: 42420-3347
Phone: (270) 830-6100

Authorized Official

Name: CHERYL ANNETTE WATHEN
Title: CFO
Phone: (812) 450-3296

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Nurse Practitioner - Family — Family	363LF0000X
Family Medicine	207Q00000X	Primary

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