Individual provider · Type 1 NPI
Edna Fells Wallace, LPN
Licensed Practical Nurse · Fayette, MS
NPI number
1255274411
Active
Practice location
1555 N. Main Street
Fayette, MS 39069
Fax (601) 786-8023
Mailing address
PO Box 194
Lorman, MS 39096-0194
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | P189022 (MS) |
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.
Another provider at this address
Other licensed practical nurse providers in Fayette
About NPI 1255274411
Edna Fells Wallace, LPN's National Provider Identifier is 1255274411, issued on Apr 13, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Fayette, MS. The record was last updated on Apr 13, 2026.