IndividualActive
Amy Medalie, NP
NPI 1003045204 · Pediatric Nurse Practitioner · Fort Worth, TX
Provider details
- NPI number
- 1003045204
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Female
- Sole proprietor
- No
- License
- 6037 (CO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4405 River Oaks Blvd
Fort Worth, TX 76114-2326
Phone: (817) 624-1770
Fax: (817) 625-1287
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 733784
Dallas, TX 75373-3784
Additional practice locations (1)
- 255 Union Blvd Ste 120Lakewood, CO 80228-1833Phone: (303) 936-7415
Registry dates
- Enumerated
- 2009-07-08
- Last updated
- 2021-04-07
- Certified
- 2021-04-07
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.