Provider Demographics
NPI:1760177877
Name:TEHAUNO, PATRICIA NAOMI (AS)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:NAOMI
Last Name:TEHAUNO
Suffix:
Gender:F
Credentials:AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 N SHAWNEE AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74801-5315
Mailing Address - Country:US
Mailing Address - Phone:405-432-9318
Mailing Address - Fax:
Practice Address - Street 1:105365 S HIGHWAY 102
Practice Address - Street 2:
Practice Address - City:MCLOUD
Practice Address - State:OK
Practice Address - Zip Code:74851-3051
Practice Address - Country:US
Practice Address - Phone:405-964-2081
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-06
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator