Organization
AVERA MCKENNAN
Active
Other names
Avera McKennan dba Avera Worthington Specialty Clinics, Avera Medical Group Worthington
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE N NORTON (CFO/SVP)
(605) 322-7818
Entity
Organization
Contact information
Practice address
1216 RYANS RD, SUITE 1, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-5789
Mailing address
1216 RYANS RD, SUITE 1, WORTHINGTON, MN 56187-1722
(507) 372-2921
(507) 372-5789
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
951015000
—
MN
Enumeration date
10/02/2006
Last updated
05/31/2017
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