person
Amy D Wallis, FNP
Family Nurse Practitioner in Fort Madison, Iowa
NPI 1275598864

Amy D Wallis is a Family Nurse Practitioner based in Fort Madison, IA and is specialized in Family. Amy D Wallis practices in Fort Madison, IA and has the professional credentials of FNP. The NPI Number for Amy D Wallis is 1275598864 and holds a License No. 71002282A (Iowa).

The current practice location address for Amy D Wallis is 5409 Avenue O, Fort Madison, IA and can be reached out via phone at 319-376-2134 and via fax at 319-376-2188. You can also correspond with Amy D Wallis through the mailing address at 5409 AVENUE O, FORT MADISON, IA - 52627-9601 (mailing address contact number: 319-376-2134).

Location: 5409 Avenue O, Fort Madison, IA, 52627-9601
person
Provider Profile Details
NPI Number
1275598864
Provider Name
Amy D Wallis
Credential
FNP
Provider Entity Type
Individual
Gender
Female
Address
5409 Avenue O, Fort Madison, IA, 52627-9601
Phone Number
319-376-2134
Fax Number
319-376-2188
Provider Enumeration Date
04/18/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1275598864 01 IA WELLMARK BLUE CROSS BLUE SHIELD
1275598864 05 IA
P00456554 01 IN RAILROAD MEDICARE
200848020A 05 IN
CG3197 01 IN MEDCARE RAILROAD GROUP
institution
Provider Business Practice Location Address Details
Address
5409 Avenue O
City
State
Zip
52627-9601
Phone Number
319-376-2134
Fax Number
319-376-2188
person
Provider Business Mailing Address Details
Address
5409 Avenue O
City
State
Zip
52627-9601
Phone Number
319-376-2134
Fax Number
319-376-2188
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
71002282A (Indiana)
Definition
Definition to come...
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