| Shannon Laiche Wallace, NP | |
|
2100 Highway 61 N, Vicksburg, MS 39183-8211 | |
| (601) 883-5000 | |
| Not Available |
| Full Name | Shannon Laiche Wallace |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 2100 Highway 61 N, Vicksburg, Mississippi |
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437084605 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 908508 (Mississippi) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Shannon Laiche Wallace, NP 1071 West St, Wesson, MS 39191-7714 Ph: (601) 883-4840 | Shannon Laiche Wallace, NP 2100 Highway 61 N, Vicksburg, MS 39183-8211 Ph: (601) 883-5000 |
Jenifer Justice, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1911 Mission 66 Ste B, Vicksburg, MS 39180 Phone: 014-562-5986 Fax: 855-830-3484 | |
Mrs. Kimberly Fuller, MSN, ACNP - BS Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2100 Highway 61 N, Vicksburg, MS 39183 Phone: 601-883-5000 | |
Mrs. Latasha Jackson Claiborne, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Jennifer Williams, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2080 S Frontage Rd, Vicksburg, MS 39180 Phone: 601-654-7070 | |
Nina Tomlinson, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 807 Monroe St, Vicksburg, MS 39183 Phone: 601-636-4356 | |
Linda Cheslek, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 807 Monroe St, Vicksburg, MS 39183 Phone: 601-636-4356 | |
Kerrie Sanders- Smith, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 4077 Pemberton Square Blvd, Vicksburg, MS 39180 Phone: 601-638-8600 |