Healthcare Provider Details

I. General information

NPI: 1750271060
Provider Name (Legal Business Name): AVERA ST LUKES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S STATE ST
ABERDEEN SD
57401-4527
US

IV. Provider business mailing address

PO BOX 5045 PROV ENRLMT PAYER STRATEGIES
SIOUX FALLS SD
57117-5045
US

V. Phone/Fax

Practice location:
  • Phone: 605-622-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DANIEL BJERKNES
Title or Position: PRESIDENT/CEO
Credential:
Phone: 605-622-5231