Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lacie A Brackeen, CFNP

Individual provider Family Nurse Practitioner · NPI 1336490713

Lacie A Brackeen, CFNP is a Nurse Practitioner in Leland, Mississippi. Qualified in 2012, 14 years ago. Practices with Indianola Clinic LLC, a 5-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
14
Licensed in
MS
In the registry since
2012

Practice location Address checks out

201 Baker Blvd
Leland, MS 38756-3401
Phone: (662) 686-4121
Fax: (662) 686-4770
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence R858018 (MS)

Record details

NPI number1336490713
Entity typeIndividual (Type 1)
GenderFemale
Credentials CFNP
Sole proprietorNo
NPI enumeratedSeptember 26, 2012
Last updated in NPPESJuly 8, 2026
Certification dateJuly 8, 2026
Mailing address201 Baker Blvd, Leland, MS 38756-3401

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Indianola Clinic Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Leland