Healthcare Provider Details

I. General information

NPI: 1932533866
Provider Name (Legal Business Name): STACEY RAZIANO SCHEXNAYDRE P.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2013
Last Update Date: 08/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12589 AIRLINE HWY
DESTREHAN LA
70047-2501
US

IV. Provider business mailing address

12589 AIRLINE HWY
DESTREHAN LA
70047-2501
US

V. Phone/Fax

Practice location:
  • Phone: 985-764-1158
  • Fax: 985-764-3142
Mailing address:
  • Phone: 985-764-1158
  • Fax: 985-764-3142

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number15367
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: