Provider Demographics
NPI:1386724052
Name:WILKINSON, MARYANN GNIADY (EDD,APRN/PMH)
Entity type:Individual
Prefix:
First Name:MARYANN
Middle Name:GNIADY
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:EDD,APRN/PMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11122 PROUDFOOT PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-1047
Mailing Address - Country:US
Mailing Address - Phone:410-992-1862
Mailing Address - Fax:
Practice Address - Street 1:6355 WOODSIDE CT
Practice Address - Street 2:HUMANIM OUTPATIENT MENTAL HEALTH CENTER
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21046-1071
Practice Address - Country:US
Practice Address - Phone:410-381-7596
Practice Address - Fax:410-381-4094
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR079204163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult