# AVERA GETTYSBURG

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Medical Group Gettysburg
- **Organization subpart:** No

## Provider details

- **NPI number:** 1366091357
- **Authorized official:** SHANTEL KREBS (INTERIM CEO)
- **Authorized official phone:** (605) 224-3144

## Contact information

- **Practice address:** 606 E GARFIELD AVE STE C, GETTYSBURG, SD 57442-1325
- **Practice address phone:** (605) 765-2273
- **Mailing address:** PO BOX 86370, SIOUX FALLS, SD 57118-6370
- **Mailing address phone:** (605) 322-4933
- **Mailing address fax:** (605) 504-9489

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 09/11/2019
- **Last updated:** 04/24/2023