Healthcare Provider Details
I. General information
NPI: 1457029076
Provider Name (Legal Business Name): ERIN MARIE MAYNARD FNP-BC, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/30/2021
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
314 GROVE NECK RD
EARLEVILLE MD
21919-3008
US
IV. Provider business mailing address
22 MASON LN
NORTH EAST MD
21901-6214
US
V. Phone/Fax
- Phone: 443-282-1197
- Fax:
- Phone: 443-340-4573
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LP0808X |
| Taxonomy | Psychiatric/Mental Health Nurse Practitioner |
| License Number | R201428 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0401X |
| Taxonomy | Addiction Medicine (Family Medicine) Physician |
| License Number | R201418 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: