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Contact Information

AVERA MCKENNAN
1001 E 21ST ST
STE. 403
SIOUX FALLS, SD57105-1033
 Phone: 605-322-1745
 Fax: 605-322-1746
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Radiologic Technologist

247100000X
Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN · (Female)

NPI Number 1548233885
Status Active
Credentials
Entity Individual
Enumeration date 02/08/2006
Last updated 03/12/2012 - About 14 years ago
Sole proprietor 1 Not specified
Identifiers
  • NE Medicaid 10025121100
  • MN Other 543R6AV BLUE PLUS
  • SD Other 370624200 DEPT OF LABOR
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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