Amelia B Waller, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

ARNP2173192 Issued in FL

Practice address

1625 SE 3Rd Ave # 601
Ft Lauderdale, FL 33316-2521

Phone

(954) 712-1115

Fax

(954) 462-5413

NPI assigned

Apr 13, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Holy Cross Hospital Inc

  • Internal Medicine Physician
  • Ft. Lauderdale, FL
  • NPI 1467401877
  NPD (past)
• Plantation Diabetes & Metabolism Clinic, LLC

  • Nurse Practitioner
  • Plantation, FL
  • NPI 1952342461
  NPD (past)
• Todd Darmody, MD, Inc

  • Endocrinology, Diabetes & Metabolism Physician
  • Fort Lauderdale, FL
  • NPI 1255575700
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199232000000",
    "number": "1013971324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE # 601",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-712-1115",
            "fax_number": "954-462-5413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SE 3RD AVE # 601",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333162521",
            "telephone_number": "954-712-1115",
            "fax_number": "954-462-5413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER",
        "first_name": "AMELIA",
        "middle_name": "B",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-13",
        "last_updated": "2008-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "ARNP2173192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Christianne Manuela Wallace, WHNP
• Jenece Wallace
• Karina M Wallace, BCBA,
• Tanya Wallen
• Veronica Wallen, RBT
• John R. Wallis, D.MIN.
• Bertram E. Walls, MD
• Matthew Walsh, M.D.
• Robert Emmett Walsh, DC
• Tricia Walsh, LCSW

• Nurse Practitioner in Ft Lauderdale, FL
• Providers in Ft Lauderdale, FL by specialty
• Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.