Provider Demographics
NPI:1417952953
Name:ZYLKA, CRAIG S (CRNP)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:S
Last Name:ZYLKA
Suffix:
Gender:M
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 W MACPHAIL RD
Mailing Address - Street 2:STE 106
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-4393
Mailing Address - Country:US
Mailing Address - Phone:410-638-8900
Mailing Address - Fax:410-638-8915
Practice Address - Street 1:2 NORTH AVE
Practice Address - Street 2:STE 101
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21014-2303
Practice Address - Country:US
Practice Address - Phone:410-838-6434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR129525363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD000975000Medicaid
MDP88845Medicare UPIN