Mrs Amy Michelle Medalie, NP - Nurse Practitioner in Fort Worth, TX

Mrs Amy Michelle Medalie, NP is a Nurse Practitioner - Pediatrics based in Fort Worth, Texas. Mrs Amy Michelle Medalie is licensed to practice in Colorado (license number 6037) and her current practice location is 4405 River Oaks Blvd, Fort Worth, Texas. She can be reached at her office (for appointments etc.) via phone at (817) 624-1770.

NPI number for Mrs Amy Michelle Medalie is 1003045204 and her current mailing address is Po Box 733784, Dallas, Texas. She does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003045204.

Contact Information

Mrs Amy Michelle Medalie, NP
4405 River Oaks Blvd,
Fort Worth, TX 76114-2326
(817) 624-1770
(817) 625-1287

Map and Direction




Provider's Profile

Full NameMrs Amy Michelle Medalie
GenderFemale
SpecialityNurse Practitioner - Pediatrics
Location4405 River Oaks Blvd, Fort Worth, Texas
Accepts Medicare AssignmentsDoes not participate in Medicare Program. She may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1003045204
  • Provider Enumeration Date: 07/08/2009
  • Last Update Date: 04/07/2021

Medical Identifiers

Medical identifiers for Mrs Amy Michelle Medalie such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003045204NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LP0200XNurse Practitioner - Pediatrics 6037 (Colorado)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Amy Michelle Medalie is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Amy Michelle Medalie, NP
Po Box 733784,
Dallas, TX 75373-3784

Ph: (682) 885-1855
Mrs Amy Michelle Medalie, NP
4405 River Oaks Blvd,
Fort Worth, TX 76114-2326

Ph: (817) 624-1770

Reviews and Comments


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