MEDICARE: TENILLE AKANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356157846
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TENILLE AKANA

Provider Business Mailing Address
First Line	:	4273 MONTGOMERY BLVD NE STE K220
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-6748
Country	:	US
Telephone Number	:	505-554-1283
Fax Number	:	505-207-6167

Provider Business Practice Location Address
First Line	:	4273 MONTGOMERY BLVD NE STE K220
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-6748
Country	:	US
Telephone Number	:	505-554-1283
Fax Number	:	505-207-6167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2024
Last Update Date	:	04/06/2026

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Directions to “ TENILLE AKANA ” Practice Location

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