Provider Demographics
NPI:1700326410
Name:WAYNIK, ERIKA (CRNP-PMH)
Entity Type:Individual
Prefix:
First Name:ERIKA
Middle Name:
Last Name:WAYNIK
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 GLENN ST STE 301&302
Mailing Address - Street 2:
Mailing Address - City:CUMBERLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21502-2573
Mailing Address - Country:US
Mailing Address - Phone:240-580-1919
Mailing Address - Fax:240-362-7409
Practice Address - Street 1:77 E MAIN ST STE 215-217
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-5037
Practice Address - Country:US
Practice Address - Phone:410-940-3254
Practice Address - Fax:410-531-2972
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-28
Last Update Date:2023-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR1829412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD120670200Medicaid