Provider Demographics
NPI:1871919860
Name:AMARTEY, LYDIA (FNP-C)
Entity type:Individual
Prefix:
First Name:LYDIA
Middle Name:
Last Name:AMARTEY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1097 LUTON DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-5663
Mailing Address - Country:US
Mailing Address - Phone:972-838-3096
Mailing Address - Fax:
Practice Address - Street 1:14525 MCCARRAN AVE
Practice Address - Street 2:APT 6307
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76155-3045
Practice Address - Country:US
Practice Address - Phone:972-838-3096
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2019-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX773090363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily