Provider Demographics
NPI:1346132016
Name:GREENFEATHER, TEENA
Entity type:Individual
Prefix:
First Name:TEENA
Middle Name:
Last Name:GREENFEATHER
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:PO BOX 148
Mailing Address - Street 2:
Mailing Address - City:VINITA
Mailing Address - State:OK
Mailing Address - Zip Code:74301-0148
Mailing Address - Country:US
Mailing Address - Phone:918-219-3528
Mailing Address - Fax:918-713-8021
Practice Address - Street 1:618 E CANADIAN AVE
Practice Address - Street 2:
Practice Address - City:VINITA
Practice Address - State:OK
Practice Address - Zip Code:74301-3810
Practice Address - Country:US
Practice Address - Phone:918-256-3424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)