Healthcare Provider Details

I. General information

NPI: 1518763002
Provider Name (Legal Business Name): KRISTI LYNN PODOLSKIY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/09/2026
Certification Date: 02/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W 7TH ST STE 28ABC
FREDERICK MD
21702-4102
US

IV. Provider business mailing address

1305 W 7TH ST STE 28ABC
FREDERICK MD
21702-4102
US

V. Phone/Fax

Practice location:
  • Phone: 301-228-3600
  • Fax: 301-228-3601
Mailing address:
  • Phone: 301-228-3600
  • Fax: 301-228-3601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR233266
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNA
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: