Provider Demographics
NPI:1487936506
Name:LEWIS, TEENA KAYE
Entity type:Individual
Prefix:MS
First Name:TEENA
Middle Name:KAYE
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TEENA
Other - Middle Name:KAYE
Other - Last Name:STERLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11205 BEL AIR PL
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-7907
Mailing Address - Country:US
Mailing Address - Phone:405-823-0755
Mailing Address - Fax:
Practice Address - Street 1:11205 BEL AIR PL
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-7907
Practice Address - Country:US
Practice Address - Phone:405-823-0755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide