MEDICARE: LAURA L WALLACE LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	148386	OH

General Provider Information

NPI Number	:	1699271080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA L WALLACE LPN

Provider Business Mailing Address
First Line	:	2518 PORTAGE GROVE CT
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-1975
Country	:	US
Telephone Number	:	330-242-9297
Fax Number	:

Provider Business Practice Location Address
First Line	:	2518 PORTAGE GROVE CT
Second Line	:
City	:	WOOSTER
State	:	OH
Zip	:	44691-1975
Country	:	US
Telephone Number	:	330-242-9297
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2018
Last Update Date	:	04/04/2018

Similar Medicare Providers

1639004484 — CHLOE E MCCOY
Practice Location Address:

2000 NOBLE DR
WOOSTER, OH
44691-5353

Practice Phone: 330-439-8492
Practice Fax:

1881105336 — NICHOLE LEE PETERS LSW
Practice Location Address:

2000 NOBLE DR
WOOSTER, OH
44691-5353

Practice Phone: 330-264-3232
Practice Fax:

1104314657 — JORJA L JOHNSON SW - A
Practice Location Address:

2000 NOBLE DR
WOOSTER, OH
44691-5353

Practice Phone: 330-264-3232
Practice Fax:

1104679265 — DUSTIN HONOUR MFT
Practice Location Address:

2587 BACK ORRVILLE RD
WOOSTER, OH
44691-9523

Practice Phone: 330-264-9597
Practice Fax: 330-264-0946

1740984558 — AUTUMN DAWN BIEBER MD
Practice Location Address:

3807 FRIENDSVILLE RD STE 209
WOOSTER, OH
44691-9601

Practice Phone: 330-345-1100
Practice Fax:

1265367841 — MACKENZIE MAULLER
Practice Location Address:

2685 ARMSTRONG RD
WOOSTER, OH
44691-9041

Practice Phone: 330-345-7949
Practice Fax:

Directions to “ LAURA L WALLACE LPN” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.