Provider Demographics
NPI:1972889400
Name:WALTON, AMYELLEN ELIZABETH (APRN-CPNP)
Entity type:Individual
Prefix:MS
First Name:AMYELLEN
Middle Name:ELIZABETH
Last Name:WALTON
Suffix:
Gender:F
Credentials:APRN-CPNP
Other - Prefix:MS
Other - First Name:AMYELLEN
Other - Middle Name:ELIZABETH
Other - Last Name:JORGENSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN-CPNP
Mailing Address - Street 1:8200 DODGE ST
Mailing Address - Street 2:CHILDREN'S HOSPITAL & MEDICAL CENTER
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4113
Mailing Address - Country:US
Mailing Address - Phone:402-955-5400
Mailing Address - Fax:
Practice Address - Street 1:8200 DODGE ST
Practice Address - Street 2:CHILDREN'S HOSPITAL & MEDICAL CENTER - PICU
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4113
Practice Address - Country:US
Practice Address - Phone:402-955-8270
Practice Address - Fax:402-955-3263
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111292363LP0222X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0222XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics, Critical Care