Provider Demographics
NPI:1427930916
Name:NYAKIO, MAKENA M (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:MAKENA
Middle Name:M
Last Name:NYAKIO
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 35TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-5307
Mailing Address - Country:US
Mailing Address - Phone:612-310-4960
Mailing Address - Fax:612-310-4960
Practice Address - Street 1:4626 35TH ST NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-5307
Practice Address - Country:US
Practice Address - Phone:612-310-4960
Practice Address - Fax:612-310-4960
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12254363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health