Individual
MIKEL INGEMANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY STE 200, DALLAS, TX 75240-6524
(972) 715-5000
(972) 715-9976
Mailing address
3705 GLENMONT DR, FORT WORTH, TX 76133-2953
(701) 220-9211
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
086956-23
NH
367500000X
Certified Registered Nurse Anesthetist
10005218
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
203945
ND
367500000X
Certified Registered Nurse Anesthetist
AP140790
TX
Other
Enumeration date
11/14/2018
Last updated
04/14/2026
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