Avera McKennan
Organization Active NPI Nurse Practitioner · Tea, SD
NPI 1831230408 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1831230408
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- AVERA MCKENNAN
- Practice address
- 725 E Figzel CT
Suite 100
Tea, SD 57064-2276 - Phone
- (605) 368-9899
- NPI assigned
- Feb 8, 2007
- Organization subpart
- No
Authorized official
- Name
- Ronald J Farr
- Title
- Sr Vice President of Finance
- Phone
- (605) 368-9899
Corporate family (same tax ID) 24
National Provider Directory
- Tax ID family
- Avera McKennan Hosp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Physician Assistant |
363A00000X | |||
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
725 E Figzel CT
Suite 100
Tea, SD 57064-2276
Mailing address
PO Box 90608
Sioux Falls, SD 57109-0608
Phone (605) 782-8313
Other names
- Avera Tea Medical Clinic
Other providers in Tea, SD
- Nicole Altman
- Gregory Franklin Alvine
- Griffin Gregory Anderson
- Aurelia Group PLLC
- Avera McKennan
- Keith M Baumgarten
- Maggie Lynn Bistodeau
- James T Brunz
- Carrie Hanson
- Kwang U Chang
All providers in Tea, SD · Nurse Practitioner in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.