Amy Dianna Wallen, FNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

2015006782 Issued in MO

Practice address

203 S Washington St
Farmington, MO 63640-1836

Phone

(573) 664-1047

NPI assigned

Feb 23, 2015

Last updated

Dec 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mineral Area Psychiatric Services LLCGroup PAC ID 3072880962, 10 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Rolla, MO, CCN 267098

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Mineral Area Psychiatric Services LLC

  • Psychiatry Physician
  • Farmington, MO
  • NPI 1306379482
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Missouri Home Care of Rolla, Inc.

  dba CenterWell Home Health

  • Home Health Agency
  • Rolla, MO
  • NPI 1366495384
  Care Compare affiliation

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

{
    "created_epoch": "1424649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1831581222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S WASHINGTON ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401836",
            "telephone_number": "573-664-1047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S WASHINGTON ST",
            "city": "FARMINGTON",
            "state": "MO",
            "postal_code": "636401836",
            "telephone_number": "573-664-1047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLEN",
        "first_name": "AMY",
        "middle_name": "DIANNA",
        "name_prefix": "Ms.",
        "credential": "FNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-02-23",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MO",
            "license": "2015006782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "420021276",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Walgreen Co (Walgreens #05624)
• Walgreen Co (Walgreens #21312)
• Melissa A Walker
• Nick S Walker
• Steven Vern Walker, L.P.C.
• Pamela Renne Wallen, PSY.D.
• Sheila Estelle Walton
• Miranda Wampler
• Breah Wheeler Ward, PLPC
• Lois E Ward, DC

• Nurse Practitioner in Farmington, MO
• Providers in Farmington, MO by specialty
• Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.