Basic Information
| Provider Information | |||||||||
| NPI: | 1477537066 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHEXNYDER | ||||||||
| FirstName: | JACQUELINE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 124 | ||||||||
| Address2: | |||||||||
| City: | LECOMPTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713460124 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3187296003 | ||||||||
| FaxNumber: | 3184835117 | ||||||||
| Practice Location | |||||||||
| Address1: | 2810 HIGHWAY 72 S | ||||||||
| Address2: | |||||||||
| City: | LECOMPTE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 713607134 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3184662105 | ||||||||
| FaxNumber: | 3184835117 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/06/2005 | ||||||||
| LastUpdateDate: | 09/13/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | AP04075 | LA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
ID Information
| ID | Type | State | Issuer | Description | 1128155 | 05 | LA | MEDICAID | 662 | 01 | LA | NURSE PRACTITIONER ADULT HEALTH | OTHER |