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

Laura Jean Wallace

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1841619848

Laura Jean Wallace is a Student in an Organized Health Care Education/Training Program in Bloomington, Minnesota. Works from 2 locations. Licensed in Minnesota and New Mexico.

Licensed in
MN, NM
In the registry since
2014
Specialties on file
2

Practice location Address checks out

8600 Nicollet Ave S
Bloomington, MN 55420-2824
Phone: (952) 541-2800
Fax: (952) 886-7015
Show map & directions

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

Additional practice locations (1)

  • Msc 10 5590, Albuquerque, NM 87131-0001 — (505) 272-5551

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence 61835 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence RS2014-0296 (NM)

Record details

NPI number1841619848
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedApril 8, 2014
Last updated in NPPESMarch 17, 2018
Mailing address8170 33rd Ave S, Minneapolis, MN 55425-4516

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