Amy M. Wallace, APRN, NNP-BC
NPI 1104178052ActiveIndividual· Nurse Practitioner, Neonatal· Lexington, KY
Nurse Practitioner, Neonatal (APRN, NNP-BC) in Lexington, Kentucky, licensed in KY, with an NPI issued in October 2012. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1104178052 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | APRN, NNP-BC |
| Sole proprietor | No |
| NPI issued | Oct 2, 2012 |
| Last updated in NPPES | Jun 6, 2024 |
| Certified by provider | Jun 6, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Neonatal Primary | 363LN0000X | 3007721 | KY |
| Nurse Practitioner, Neonatal, Critical Care | 363LN0005X | 3007721 | KY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (KY) |
|---|
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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