Provider Demographics
NPI:1841229929
Name:MCKINNON, NAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:NAYA
Middle Name:
Last Name:MCKINNON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NAYAB
Other - Middle Name:
Other - Last Name:MAHAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7575 W WASHINGTON AVE
Mailing Address - Street 2:SUITE 127-160
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4333
Mailing Address - Country:US
Mailing Address - Phone:702-505-4230
Mailing Address - Fax:702-505-4231
Practice Address - Street 1:351 N BUFFALO DR
Practice Address - Street 2:SUITE B
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89145-0301
Practice Address - Country:US
Practice Address - Phone:702-505-4230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-01
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ37710207R00000X
NV14081207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine