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

Individual provider Nurse Practitioner · NPI 1952321200

Donna D Wallace, ANP is a Nurse Practitioner in Minneapolis, Minnesota. Qualified in 1996, 30 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
30
Licensed in
MN
In the registry since
2006
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Practice location Address checks out

920 E 28th St Ste 700
Minneapolis, MN 55407-1139
Phone: (612) 863-9062
Fax: (612) 863-9252
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence R1248670 (MN)

Record details

NPI number1952321200
Entity typeIndividual (Type 1)
GenderFemale
Credentials ANP
Sole proprietorNo
NPI enumeratedJuly 20, 2006
Last updated in NPPESJuly 8, 2007

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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