Healthcare Provider Details

I. General information

NPI: 1417240300
Provider Name (Legal Business Name): KIMBERLY D KINDT CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/25/2011
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2154 DUCK SLOUGH BLVD
TRINITY FL
34655-5073
US

IV. Provider business mailing address

2154 DUCK SLOUGH BLVD
TRINITY FL
34655-5073
US

V. Phone/Fax

Practice location:
  • Phone: 727-937-6020
  • Fax: 866-665-2702
Mailing address:
  • Phone: 727-937-6020
  • Fax: 866-665-2702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberARNP9249045
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: