Healthcare Provider Details

I. General information

NPI: 1992587125
Provider Name (Legal Business Name): LAVALDA BEANS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAVALDA LYONS

II. Dates (important events)

Enumeration Date: 10/23/2023
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3035 E PALMER WASILLA HWY STE 301
WASILLA AK
99654-7274
US

IV. Provider business mailing address

4120 LAUREL ST
ANCHORAGE AK
99508-5392
US

V. Phone/Fax

Practice location:
  • Phone: 877-522-1275
  • Fax: 833-888-7145
Mailing address:
  • Phone: 907-575-5949
  • Fax: 907-561-1416

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number215923
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: