| Organization Name: | DEACONESS CLINIC, INC |
| NPI Number: | 1003159997 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LINDA E WHITE (PRESIDENT/ CEO) |
| Mailing Address: | 1035 N Elm St Henderson |
| State: | KY US |
| Postal Code: | 424202712 |
| Phone Number: | 2708274596 |
| Fax Number: | 2708262838 |
| NPI Enumeration Date: | 03/29/2013 |
| NPI Last Update Date: | 03/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |