Amber Wallenbrock, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2015017612 Issued in MO

Practice address

4 Hickory Ridge Rd
Hillsboro, MO 63050-5100

Phone

(636) 481-6040

NPI assigned

Jun 17, 2020

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)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Comtrea, Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Festus, MO
  • NPI 1023258878
  NPD

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1033735857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 EAST MAIN ST",
            "city": "FESTUS",
            "state": "MO",
            "postal_code": "630281952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 HICKORY RIDGE RD",
            "city": "HILLSBORO",
            "state": "MO",
            "postal_code": "630505100",
            "telephone_number": "636-481-6040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLENBROCK",
        "first_name": "AMBER",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MO",
            "license": "2015017612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Marcell Turner, DO
• Lisa M Vasel
• Rhonda J Viars, SLP-A
• Ross Vollmer, DC
• Katherine Leigh Wagner, FNP
• Maddesyn Larren Warren
• Tiffany Erin Webster, LCSW
• Joshua White
• Kimberly Dawn Wilson, LPC
• Sonja Wooten, RDH

• Registered Nurse in Hillsboro, MO
• Providers in Hillsboro, MO by specialty
• Registered Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2020; 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.