AVERA MCKENNAN HOSPITAL MEDICAL STAFF NPI 1275984403

NPI Information

NPI: 1275984403
Provider Name: AVERA MCKENNAN HOSPITAL MEDICAL STAFF
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 43D0658878

Address:
1325 S CLIFF AVE
PLAZA 4
SIOUX FALLS, SD
ZIP 57105
Phone: (605) 322-6792
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AVERA MCKENNAN HOSPITAL MEDICAL STAFF is a family nurse practitioner in Sioux Falls, SD. AVERA MCKENNAN HOSPITAL MEDICAL STAFF NPI is 1275984403. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1325 S CLIFF AVE
PLAZA 4
SIOUX FALLS, SD
ZIP 57105-007
Phone: (605) 322-6792

The provider's authorized official is Justin Garry .
The authorized official title is Clinic Administrative Manager and has the following contact phone number (605) 322-6792.

The CLIA number assigned to this NPI record is 43D0658878 - hospital with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 6/29/2016 and was last updated on 6/29/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	CP001103	SOUTH DAKOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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