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Laura Jean Wallace
Pediatrics Physician in Bloomington, Minnesota
NPI 1841619848

Laura Jean Wallace is a Pediatrics Physician based in Minneapolis, MN. Laura Jean Wallace practices in Bloomington, MN. The NPI Number for Laura Jean Wallace is 1841619848 and holds a License No. RS2014-0296 (Minnesota).

The current practice location address for Laura Jean Wallace is 8600 Nicollet Ave S, Bloomington, MN and can be reached out via phone at 952-541-2800 and via fax at 952-886-7015.

Location: 8600 Nicollet Ave S, Bloomington, MN, 55425-4516
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1841619848
Provider Name
Laura Jean Wallace
Credential
Provider Entity Type
Individual
Gender
Female
Address
8600 Nicollet Ave S, Bloomington, MN, 55425-4516
Phone Number
952-541-2800
Fax Number
952-886-7015
Provider Enumeration Date
04/08/2014
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
8600 Nicollet Ave S
City
Bloomington
State
Minnesota
Zip
55420-2824
Phone Number
952-541-2800
Fax Number
952-886-7015
person
Provider Business Mailing Address Details
Address
8600 Nicollet Ave S
City
Bloomington
State
Minnesota
Zip
55420-2824
Phone Number
952-541-2800
Fax Number
952-886-7015
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Pediatrics
Speciality
-
Taxonomy
208000000X
License No.
61835 (Minnesota)
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
RS2014-0296 (New Mexico)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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