Healthcare Provider Details

I. General information

NPI: 1740669787
Provider Name (Legal Business Name): KIRSTYN INDGJER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2015
Last Update Date: 02/27/2026
Certification Date: 02/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 E LAS OLAS BLVD
FORT LAUDERDALE FL
33301-2334
US

IV. Provider business mailing address

2001 N OCEAN BLVD APT 404S
FORT LAUDERDALE FL
33305-3753
US

V. Phone/Fax

Practice location:
  • Phone: 305-360-5083
  • Fax:
Mailing address:
  • Phone: 917-932-6132
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2074
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number670477
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number11019520
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number907485
License Number StateTX
# 5
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11019520
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: