Provider Demographics
NPI:1013884154
Name:CHEROKEE NATION PUBLIC HEALTH
Entity type:Organization
Organization Name:CHEROKEE NATION PUBLIC HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPECIAL PROJECTS OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:WHITEWATER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:918-772-4105
Mailing Address - Street 1:1325 E BOONE ST
Mailing Address - Street 2:
Mailing Address - City:TAHLEQUAH
Mailing Address - State:OK
Mailing Address - Zip Code:74464-3361
Mailing Address - Country:US
Mailing Address - Phone:918-772-4105
Mailing Address - Fax:
Practice Address - Street 1:1325 E BOONE ST
Practice Address - Street 2:
Practice Address - City:TAHLEQUAH
Practice Address - State:OK
Practice Address - Zip Code:74464-3361
Practice Address - Country:US
Practice Address - Phone:918-772-4105
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CHEROKEE NATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare