Wallace, Laura Jean

Wallace, Laura Jean is an individual health care provider with primary practice located at 8600 Nicollet Ave S , Bloomington MN 55420-2824. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Wallace, Laura Jean can be contacted via phone (952) 541-2800.

Contact Information

Primary practice address
8600 Nicollet Ave S Bloomington MN 55420-2824
Phone: (952) 541-2800
Fax: (952) 886-7015
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X RS2014-0296 New Mexico
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 61835 Minnesota

Profile Details

NPI number 1841619848
LBN Legal business name Wallace, Laura Jean
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 8th, 2014
Last updated Mar 17th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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