Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Deaconess Clinic, Inc

Organization Family Medicine Physician · NPI 1104445014

Deaconess Clinic, Inc is a Family Medicine Physician in Henderson, Kentucky. Registered with an NPI since 2020.

In the registry since
2020
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

471 Klutey Park Plaza Dr
Henderson, KY 42420-3347
Phone: (270) 830-6100
Fax: (270) 826-3089
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X
Nurse Practitioner Taxonomy 363L00000X
Family Nurse Practitioner Taxonomy 363LF0000X

Record details

NPI number1104445014
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Cheryl Wathen — Cfo · (812) 450-3296
Other names Deaconess Clinic Klutey Park
NPI enumeratedApril 10, 2020
Last updated in NPPESApril 10, 2020
Certification dateApril 10, 2020
Mailing addressPo Box 1510, Evansville, IN 47706-1510

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