# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Avera Lee Mabee OB/GYN
- **Organization subpart:** No

## Provider details

- **NPI number:** 1629052451
- **Authorized official:** JULIE NORTON (CFO/SVP)
- **Authorized official phone:** (605) 322-7818

## Contact information

- **Practice address:** 1910 W 69TH ST, SUITE 100, SIOUX FALLS, SD 57108-5612
- **Practice address phone:** (605) 322-5260
- **Practice address fax:** (605) 322-5265
- **Mailing address:** PO BOX 84632, SIOUX FALLS, SD 57118-4632
- **Mailing address phone:** (605) 322-5260
- **Mailing address fax:** (605) 322-5265

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 2481 | SD | Yes |

## Other

- **Enumeration date:** 12/05/2005
- **Last updated:** 05/31/2017