Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Richard Wallace, APRN

Individual provider Certified Registered Nurse Anesthetist · NPI 1275163263

Jacob Richard Wallace, APRN is a Certified Registered Nurse Anesthetist (CRNA) in Rochester, Minnesota. Qualified in 2020, 6 years ago. Practices with Mayo Clinic, a 4,796-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
6
Licensed in
MN
In the registry since
2020
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

200 1st St SW
Rochester, MN 55905-0001
Phone: (507) 284-2511
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 2447 (MN)

Record details

NPI number1275163263
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorNo
NPI enumeratedJanuary 19, 2020
Last updated in NPPESOctober 5, 2020
Certification dateOctober 5, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Mayo Clinic — 4796 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rochester