Provider Demographics
NPI:1689466617
Name:ENENODION, TEELAN PONYEH SLANGER
Entity type:Individual
Prefix:
First Name:TEELAN
Middle Name:PONYEH SLANGER
Last Name:ENENODION
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 NW DES MOINES ST
Mailing Address - Street 2:
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-2308
Mailing Address - Country:US
Mailing Address - Phone:515-305-5743
Mailing Address - Fax:
Practice Address - Street 1:3704 NW DES MOINES ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-2308
Practice Address - Country:US
Practice Address - Phone:515-305-5743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-17
Last Update Date:2025-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care