Individual
AMANDA SHAY TICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Contact information
Practice address
1000 HOUSTON STREET, SUITE 200, FORT WORTH, TX 76102
(817) 336-0551
(817) 339-3940
Mailing address
1000 HOUSTON STREET, SUITE 200, FORT WORTH, TX 76102
(817) 336-0551
(817) 339-3940
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
703553
TX
Other
Enumeration date
06/14/2013
Last updated
12/22/2015
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