SHANNON LAICHE WALLACE NP
NPI 1437084605
Nurse Practitioner in Vicksburg, MS

NPI Status: Active since June 17, 2026

Contact Information

2100 HIGHWAY 61 N
VICKSBURG, MS
ZIP 39183
Phone: (601) 883-5000

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Newly Listed Provider
This NPI profile has been added to the NPI registry within the last 30 days.

Table of Contents

NPI Profile Information
Primary Taxonomy
Group Taxonomy
NPI Validation
Other Providers Same Location
Frequently Asked Questions

Individual
Female
Nurse Practitioner

About SHANNON WALLACE

This page provides the complete NPI Profile along with additional information for Shannon Wallace, a provider established in Vicksburg, Mississippi with a medical specialization in Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1437084605 assigned on June 2026. The practitioner's primary taxonomy code is 363L00000X with license number 908508 (MS). The provider is registered as an individual and her NPI record was last updated June 2026. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization.

NPI: 1437084605
Provider Name: SHANNON LAICHE WALLACE NP
Gender: Female
Entity Type: Individual
Location Address: 2100 HIGHWAY 61 N VICKSBURG, MS 39183
Location Phone: (601) 883-5000
Mailing Address: 1071 WEST ST WESSON, MS 39191
Mailing Phone: (601) 883-4840
Is Sole Proprietor?: Yes
Enumeration Date: 06-17-2026
Last Update Date: 06-17-2026
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A nurse practitioner (NP) like Shannon Wallace is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification: Nurse Practitioner
Taxonomy Code: 363L00000X
Type: Physician Assistants & Advanced Practice Nursing Providers
License No.: 908508
License State: MS
Taxonomy Description: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1437084605, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 65. The final step is to find the difference between that total and the next multiple of ten (70 - 65 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1

Doubled → 2

Pos 2

Unchanged

Pos 3

Doubled → 6

Pos 4

Unchanged

Pos 5

Doubled → 0

Pos 6

Unchanged

Pos 7

Doubled → 8

Pos 8

Unchanged

Pos 9

Doubled → 0

Check

Target digit

Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 3 → 6 0 → 0 4 → 8 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 6 + 7 + 0 + 8 + 8 + 6 + 0 + 24 = 65

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 65 is 70. The difference is the calculated check digit.

70 - 65 = 5

This NPI is valid

The calculated check digit is 5, which matches the last digit of 1437084605.