Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Amy D Wallis, FNP

Individual provider Family Nurse Practitioner · NPI 1275598864

Amy D Wallis, FNP is a Nurse Practitioner in Fort Madison, Iowa. Qualified in 2005, 21 years ago. Practices with Southeast Iowa Regional Medical Center Inc, a 258-clinician group and accepts Medicare assignment. Licensed in Iowa and Indiana.

Years since qualifying
21
Licensed in
IA, IN
In the registry since
2006
Specialties on file
2
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

5409 Avenue O
Fort Madison, IA 52627-9601
Phone: (319) 376-2134
Fax: (319) 376-2188
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 100507 (IA)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 71002282A (IN)

Record details

NPI number1275598864
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedApril 18, 2006
Last updated in NPPESOctober 6, 2011

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2005 (21 years in practice)
Group practice Southeast Iowa Regional Medical Center Inc — 258 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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