Healthcare Provider Details

I. General information

NPI: 1235064973
Provider Name (Legal Business Name): TENKILLER INTEGRATIVE FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 S THORNTON ST
VIAN OK
74962-5031
US

IV. Provider business mailing address

PO BOX 1
COOKSON OK
74427-0001
US

V. Phone/Fax

Practice location:
  • Phone: 918-552-0562
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RAGAN BIRCKEL
Title or Position: APRN
Credential: APRN, FNP-C, FIM-P
Phone: 918-710-0444