| NPI | 1174007132 |
|---|---|
| Doing Business As | DEACONESS PAIN CLINIC MOB5 |
| Entity Type | Organization |
| Authorized Contact | CHERYL ANNETTE WATHEN CFO 812-450-3296 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 363LF0000X Nurse Practitioner, Family | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2018-09-17 |
| Last Update Date | 2019-07-12 |