Provider Demographics
NPI:1285836940
Name:PODANY, KRISTA MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:KRISTA
Middle Name:MARIE
Last Name:PODANY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2719 N 64TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68104-4035
Mailing Address - Country:US
Mailing Address - Phone:402-933-7914
Mailing Address - Fax:
Practice Address - Street 1:13530 DISCOVERY DR
Practice Address - Street 2:SUITE 18
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3034
Practice Address - Country:US
Practice Address - Phone:402-758-0503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist