Provider Demographics
NPI:1770265415
Name:OAKLAND, TENA
Entity type:Individual
Prefix:
First Name:TENA
Middle Name:
Last Name:OAKLAND
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 1:201 5TH ST NW UNIT 790
Mailing Address - Street 2:
Mailing Address - City:WATFORD CITY
Mailing Address - State:ND
Mailing Address - Zip Code:58854-7118
Mailing Address - Country:US
Mailing Address - Phone:701-444-7469
Mailing Address - Fax:701-444-6436
Practice Address - Street 1:201 5TH ST NW UNIT 790
Practice Address - Street 2:
Practice Address - City:WATFORD CITY
Practice Address - State:ND
Practice Address - Zip Code:58854-7118
Practice Address - Country:US
Practice Address - Phone:701-444-7469
Practice Address - Fax:701-444-6436
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND1609294321Medicaid