Provider Demographics
NPI:1235582438
Name:MCABEE, LACIE (DNP)
Entity Type:Individual
Prefix:DR
First Name:LACIE
Middle Name:
Last Name:MCABEE
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-0194
Mailing Address - Country:US
Mailing Address - Phone:662-612-6089
Mailing Address - Fax:662-612-6313
Practice Address - Street 1:565 N ROBINSON ST
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2118
Practice Address - Country:US
Practice Address - Phone:662-612-6089
Practice Address - Fax:662-612-6313
Is Sole Proprietor?:No
Enumeration Date:2016-07-22
Last Update Date:2022-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21551363LP0808X
MS901602363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ027727Medicaid
MS07375851Medicaid