Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic | |
Family Medicine |
207Q00000X | 08 | Physician/Family Practice | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI Number | 1831345792 |
| LBN Legal business name | DEACONESS CLINIC, INC |
| Authorized official | CHERYL WATHEN - (CFO) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 08/12/2008 |
| Last updated | 08/10/2017 - About 9 years ago |
| Identifiers | n/a |
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DEACONESS CLINIC, INC
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