Avera Mckennan | |
4400 W 69th St Ste 3100 Sioux Falls SD 57108-8170 | |
(605) 504-3522 | |
(605) 322-4345 |
Full Name | Avera Mckennan |
---|---|
Speciality | Psychiatry & Neurology - Addiction Medicine |
Location | 4400 W 69th St Ste 3100, Sioux Falls, South Dakota |
Authorized Official Name and Position | David William Flicek (PRESIDENT/CEO) |
Authorized Official Contact | 6053227915 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Avera Mckennan Po Box 86370 Sioux Falls SD 57118-6370 Ph: (605) 322-6408 | Avera Mckennan 4400 W 69th St Ste 3100 Sioux Falls SD 57108-8170 Ph: (605) 504-3522 |
NPI Number | 1013668698 |
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Provider Enumeration Date | 01/14/2022 |
Last Update Date | 01/14/2022 |
Certification Date | 01/14/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1013668698 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084A0401X | Psychiatry & Neurology - Addiction Medicine | (* (Not Available)) | Primary |
363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
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