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Contact Information

AVERA MCKENNAN
1417 S. CLIFF AVE.
STE. 100
SIOUX FALLS, SD57105-1063
 Phone: 605-322-8937
 Fax: 605-322-8938
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Maternal & Fetal Medicine

207VM0101X 16 Physician/Obstetrics & Gynecology
Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN · (Female)

NPI # 1205808748
Status Active
Credentials
Entity Individual
Enumeration date 02/07/2006
Last updated 03/12/2026 - About 3 months ago
Sole proprietor 1 Not specified
Identifiers
  • IA Medicaid 0573360
  • MN Medicaid 482413000
  • NE Medicaid 10025040700
  • MN Other 361ROPE BCBS
  • MN Other 361R1WA BLUE PLUS
  • SD Other 4994376 BCBS
  • SD Other 370624200 DEPT OF LABOR
  • SD Other 95736 HEALTHPARTNERS
  • SD Other 924114229808 PRIMEWEST
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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