| Organization Name: | AVERA MCKENNAN |
| NPI Number: | 1912936535 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JULIE N NORTON (CFO) |
| Mailing Address: | 400 22nd Ave. Brookings |
| State: | SD US |
| Postal Code: | 570062497 |
| Phone Number: | 6056979500 |
| Fax Number: | 6056976939 |
| NPI Enumeration Date: | 07/03/2006 |
| NPI Last Update Date: | 03/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |