Deaconess Clinic INC

NPI #1104617141 in Jasper, Indiana

Provider Information

NPI Number: 1104617141
Entity Type: Organization
Organization Name: Deaconess Clinic INC
Primary Specialty: Pediatrics
Enumeration Date: May 16, 2025
Last Updated: May 16, 2025

Practice Location

Address: 721 W 13TH ST
City: Jasper
State: Indiana
ZIP Code: 47546-1855
Phone: (812) 996-7918

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X
Physician Assistant	363A00000X
Pediatrics	208000000X	Primary

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