NPI 1003159997 · live from the CMS NPI Registry
Deaconess Clinic, INC
Pediatrics in Henderson, KY. National Provider Identifier 1003159997, active.
NPI record
| NPI | 1003159997 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics 208000000X |
| Practice location | 1035 N Elm St, Henderson, KY 42420 |
| Practice phone | 270-827-4596 |
| Mailing address | Po Box 1510, Evansville, IN 47706 |
| Enumerated | March 29, 2013 |
| Last updated | August 10, 2017 |
| Authorized official | Cheryl Wathen, Cfo |
| Other names | Deaconess Clinic I |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics | 363LP0200X | — |
| Pediatrics primary | 208000000X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.