National Provider Identifier Database

EDNA F WALLACE, LPN – NPI #1255274411
Licensed Practical Nurse

An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.


Contact Information

EDNA F WALLACE, LPN
1555 N. MAIN STREET
FAYETTE, MS39069
Phone: 601-786-8091
Fax: 601-786-8023
Website:
Specialty Taxonomy Code
* Licensed Practical Nurse 164W00000X

* Indicates primary specialty

NPI Profile & details for EDNA F WALLACE

NPI Number 1255274411
Credentials LPN (Licensed Practical Nurse)
Entity Individual
Enumeration date 04/13/2026
Last updated 04/13/2026 - About 2 months ago
Sole proprietor1 No
Identifiers
  • MS License #: P189022
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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