Organization · NPI-2
Avera Mckennan
Orthopaedic Surgery · Sioux City, IA
NPI number1619891850
StatusActive
Last updated in NPPESAug 31, 2026
Details
- NPI
- 1619891850
- Entity type
- Organization (NPI-2)
- Legal business name
- Avera Mckennan
- Organization subpart
- Yes
- Enumeration date
- Aug 10, 2026
- Certification date
- Aug 31, 2026
- Last updated
- Aug 31, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207X00000X | Orthopaedic Surgery | – | – | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Avera Cnos Northside Dme (Doing Business As)
Practice location
2735 Outer Dr NSioux City, IA 51104-1590
Phone 605-217-2667
Mailing address
575 N Sioux Point RdDakota Dunes, SD 57049-5312
Phone 605-217-2667
Authorized official
Ronald Place
Regional President/Ceo
6053227903
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