Provider Demographics
NPI:1932819430
Name:NAVA, MCKENZIE BROOKLIN (PMHNP-BC, DNP, RN)
Entity type:Individual
Prefix:
First Name:MCKENZIE
Middle Name:BROOKLIN
Last Name:NAVA
Suffix:
Gender:F
Credentials:PMHNP-BC, DNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2791 FREDERICK DOUGLASS BLVD
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3006
Mailing Address - Country:US
Mailing Address - Phone:917-858-6291
Mailing Address - Fax:718-304-1605
Practice Address - Street 1:2791 FREDERICK DOUGLASS BLVD
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10039-3006
Practice Address - Country:US
Practice Address - Phone:917-858-6291
Practice Address - Fax:718-304-1605
Is Sole Proprietor?:No
Enumeration Date:2022-11-25
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY406269363LP0808X
NY853799163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse