=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124915376
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LAKAN NICOLE BEARD APRN, PMHNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2025
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 66755 STATE ST
-----------------------------------------------------
City | CAMBRIDGE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43725-8757
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 800-668-0336
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3312 DALE RD
-----------------------------------------------------
City | ZANESVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43701-1307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-704-2818
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | RN.457554
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LP0808X
-----------------------------------------------------
Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0038678
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------