Healthcare Provider Details

I. General information

NPI: 1972889400
Provider Name (Legal Business Name): AMYELLEN ELIZABETH WALTON CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMYELLEN ELIZABETH JORGENSON APRN-CPNP

II. Dates (important events)

Enumeration Date: 10/28/2011
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8200 DODGE ST CHILDREN'S NEBRASKA
OMAHA NE
68114-4113
US

IV. Provider business mailing address

8200 DODGE ST CHILDREN'S NEBRASKA
OMAHA NE
68114-4113
US

V. Phone/Fax

Practice location:
  • Phone: 402-955-4747
  • Fax: 402-955-5874
Mailing address:
  • Phone: 402-955-5400
  • Fax: 402-955-5874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number111292
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: