Healthcare Provider Details

I. General information

NPI: 1477537066
Provider Name (Legal Business Name): JACQUELINE ANN SCHEXNYDER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 09/13/2021
Certification Date: 08/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 HIGHWAY 72 S
LECOMPTE LA
71360-7134
US

IV. Provider business mailing address

PO BOX 124
LECOMPTE LA
71346-0124
US

V. Phone/Fax

Practice location:
  • Phone: 318-466-2105
  • Fax: 318-483-5117
Mailing address:
  • Phone: 318-729-6003
  • Fax: 318-483-5117

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP04075
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: