Provider Demographics
NPI:1568190759
Name:LALAS, BETH (CRNP)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:
Last Name:LALAS
Suffix:
Gender:F
Credentials:CRNP
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 2048
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36652-2048
Mailing Address - Country:US
Mailing Address - Phone:251-436-7646
Mailing Address - Fax:251-436-7765
Practice Address - Street 1:201 D'OLIVE
Practice Address - Street 2:201 D'OLIVE ST
Practice Address - City:BAY MINETTE
Practice Address - State:AL
Practice Address - Zip Code:36507
Practice Address - Country:US
Practice Address - Phone:251-706-8700
Practice Address - Fax:251-937-6169
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL9420228163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse