Laura Wallace, CNP, DNP-FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10747 Issued in MN

Practice address

14040 Northdale Blvd
Rogers, MN 55374-9612

Phone

(763) 488-4100

NPI assigned

Nov 16, 2023

Last updated

Nov 16, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fairview ClinicsGroup PAC ID 7113830142, 799 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fairview Northland Regional Hospital Hospital, Princeton, MN, CCN 240141

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Fairview Clinics

  dba Fairview Clinics-Hiawatha

  • Primary Care Clinic/Center
  • Minneapolis, MN
  • NPI 1346432218
  Medicare reassignment Care Compare group NPD
• Fairview Express Care

  dba M Health Fairview Recovery Clinic

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1053952606
  Medicare reassignment NPD
• Fairview Health Services

  • Emergency Medicine Physician
  • Minneapolis, MN
  • NPI 1811077175
  Medicare reassignment NPD
• Fairview Clinics

  dba M Health Fairview Clinic - Elk River

  • Primary Care Clinic/Center
  • Elk River, MN
  • NPI 1144474305
  NPD
• Fairview Clinics

  • Primary Care Clinic/Center
  • Saint Paul, MN
  • NPI 1396552147
  NPD
• Fairview Express Care

  • General Practice Physician
  • Edina, MN
  • NPI 1831707207
  NPD
• Fairview Express Care

  • General Practice Physician
  • Minneapolis, MN
  • NPI 1871101238
  NPD
• Fairview Health Services

  dba Fairview Hospital University

  • General Acute Care Hospital
  • Minneapolis, MN
  • NPI 1013994359
  NPD
• Fairview Health Services

  dba Fairview Emergency Medical Services

  • Land Ambulance
  • Saint Paul, MN
  • NPI 1710212485
  NPD
• Fairview Health Services

  dba Fairview Northland Hospital

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1922085299
  NPD
• Fairview Clinics

  dba Fairview Clinics-New Brighton

  • Primary Care Clinic/Center
  • New Brighton, MN
  • NPI 1881673002
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Fairview Health Services

  dba Fairview Diagnostic Laboratory

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1841351749
  Care Compare affiliation
• Fairview Health Services

  dba Fairview Northland Hospital

  • General Acute Care Hospital
  • Princeton, MN
  • NPI 1922085299
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1700092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1215702683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13060 42ND AVE SW",
            "city": "PILLAGER",
            "state": "MN",
            "postal_code": "564732495",
            "telephone_number": "763-291-5193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14040 NORTHDALE BLVD",
            "city": "ROGERS",
            "state": "MN",
            "postal_code": "553749612",
            "telephone_number": "763-488-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "LAURA",
        "credential": "CNP, DNP-FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "10747",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Wahl
• Sarah J Walentiny
• Walgreen Co (Walgreens #07812)
• Walkoviak Optometry LLC
• Ashley Walkoviak, O.D.
• Gabrielle Louise Walstrom
• Ashley Walters, LCSW
• Denise Andrea Washington-Wilson
• Leslie Weber
• Julie Allison Weinans, PT

• Family Nurse Practitioner in Rogers, MN
• Providers in Rogers, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.