Organization
AVERA MCKENNAN
Active
Other names
Avera Medical Group Spencer
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JULIE N NORTON (V.P. FINANCE)
(605) 322-6375
Entity
Organization
Contact information
Practice address
116 E 11TH ST, SUITE 101, SPENCER, IA 51301-4364
(712) 264-3500
(712) 264-3535
Mailing address
116 E 11TH ST, SUITE 101, SPENCER, IA 51301-4364
(712) 264-3500
(712) 264-3535
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IA
363A00000X
Physician Assistant
—
IA
363LF0000X
Family Nurse Practitioner
—
IA
363LP0200X
Pediatric Nurse Practitioner
—
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0252791
—
IA
Enumeration date
01/19/2006
Last updated
03/12/2012
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