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

Laura Wallace, CNP, DNP-FNP

Individual provider Family Nurse Practitioner · NPI 1215702683

Laura Wallace, CNP, DNP-FNP is a Nurse Practitioner in Rogers, Minnesota. Qualified in 2023, 3 years ago. Practices with Fairview Clinics, a 806-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
3
Licensed in
MN
In the registry since
2023
What do these letters mean?
CNP — Certified Nurse Practitioner
A certified nurse practitioner.

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Practice location Address checks out

14040 Northdale Blvd
Rogers, MN 55374-9612
Phone: (763) 488-4100
Show map & directions

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

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 10747 (MN)

Record details

NPI number1215702683
Entity typeIndividual (Type 1)
GenderFemale
Credentials CNP , DNP-FNP
Sole proprietorNo
NPI enumeratedNovember 16, 2023
Last updated in NPPESNovember 16, 2023
Certification dateNovember 16, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Fairview Clinics — 806 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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