National Provider Identifier Database

AVERA MCKENNAN
Radiologic Technologist

A medical imaging or radiation therapy professional who is appropriately educated and trained to perform medical imaging procedures using ionizing and nonionizing radiation.


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
* Radiologic Technologist 247100000X

* Indicates primary specialty

NPI Profile & details for AVERA MCKENNAN

NPI Number 1548233885
Legal business name
LBN
AVERA MCKENNAN
Authorized official JULIE NORTON - (SENIOR VP OF FINANCE)
Entity Organization
Organization subpart No
Enumeration date 02/08/2006
Last updated 03/12/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • NE Medicaid: 10025121100
  • MN Other: 543R6AV BLUE PLUS
  • SD Other: 370624200 DEPT OF LABOR

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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