Provider Demographics
NPI:1114747532
Name:CHENEY, AMANDA JO (FNP-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:JO
Last Name:CHENEY
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 1:901 MCCURRY AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-7848
Mailing Address - Country:US
Mailing Address - Phone:817-966-7370
Mailing Address - Fax:
Practice Address - Street 1:1725 CHADWICK CT STE 100
Practice Address - Street 2:
Practice Address - City:HURST
Practice Address - State:TX
Practice Address - Zip Code:76054-3351
Practice Address - Country:US
Practice Address - Phone:817-281-4446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1177682363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily