| Ms Amy Dianna Wallen, FNP | |
|
10 Lake Dr, Bonne Terre, MO 63628-1820 | |
| (573) 271-5317 | |
| (573) 335-6724 |
| Full Name | Ms Amy Dianna Wallen |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 11 Years |
| Location | 10 Lake Dr, Bonne Terre, Missouri |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831581222 | NPI | - | NPPES |
| 420021276 | Medicaid | MO |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 2015006782 (Missouri) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Kindred At Home | Rolla, MO | Home health agency |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Missouri Medical Providers Llc | 2365855913 | 9 |
| Mineral Area Psychiatric Services Llc | 3072880962 | 8 |
| Entity Name | Mineral Area Psychiatric Services Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306379482 PECOS PAC ID: 3072880962 Enrollment ID: O20170524002469 |
| Entity Name | Missouri Medical Providers Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043817323 PECOS PAC ID: 2365855913 Enrollment ID: O20201229000683 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Amy Dianna Wallen, FNP 2215 Broadway St, Cape Girardeau, MO 63701-4403 Ph: (573) 271-5317 | Ms Amy Dianna Wallen, FNP 10 Lake Dr, Bonne Terre, MO 63628-1820 Ph: (573) 271-5317 |
Ms. Mary Suzanne Jones, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2727 Highway K, Bonne Terre, MO 63628 Phone: 573-358-5516 | |
Rachel Ann Francis, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 55 Nesbit Dr, Bonne Terre, MO 63628 Phone: 573-358-1700 Fax: 573-358-1702 | |
Mrs. Ann Mirette Kirby, PMHNP-BC Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 11 S Division St Ste A, Bonne Terre, MO 63628 Phone: 573-723-1100 Fax: 573-723-1130 | |
Mrs. Lacey Sullivan, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 7245 Raider Rd Ste C, Bonne Terre, MO 63628 Phone: 573-358-4600 Fax: 573-358-4654 | |
Glenda Charlene Counts, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 11 S Division St Ste A, Bonne Terre, MO 63628 Phone: 573-723-1100 Fax: 573-723-1130 | |
Mrs. Ronay Rodgers, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 527 Benham St, Bonne Terre, MO 63628 Phone: 573-358-9119 Fax: 573-358-9489 | |
Melody Kay Willis, MSN, RN, PMHNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1857 Rue Lamande, Bonne Terre, MO 63628 Phone: 573-300-2690 |