Provider Demographics
NPI:1548142565
Name:LACEFIELD, ANNAH CATHERINE (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ANNAH
Middle Name:CATHERINE
Last Name:LACEFIELD
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-1506
Mailing Address - Country:US
Mailing Address - Phone:662-292-7328
Mailing Address - Fax:
Practice Address - Street 1:830 W POPLAR AVE STE 2
Practice Address - Street 2:
Practice Address - City:COLLIERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38017-4046
Practice Address - Country:US
Practice Address - Phone:901-673-4061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-22
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN39158363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics