# AVERA MCKENNAN

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** AVERA MCKENNAN
- **Other names:** Avera Medical Group Worthington Surgery Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1922357839
- **Legal business name:** AVERA MCKENNAN
- **Authorized official:** KELLI VANGROUW (CLINIC MANAGER)
- **Authorized official phone:** (507) 372-2921

## Contact information

- **Practice address:** 1216 RYANS RD, SUITE 2, WORTHINGTON, MN 56187-1722
- **Practice address phone:** (507) 372-2921
- **Practice address fax:** (507) 372-5789
- **Mailing address:** 1216 RYANS RD, SUITE 2, WORTHINGTON, MN 56187-1722
- **Mailing address phone:** (507) 372-2921
- **Mailing address fax:** (507) 372-5789

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/06/2012
- **Last updated:** 06/03/2015