Healthcare Provider Details

I. General information

NPI: 1003721440
Provider Name (Legal Business Name): JANELL MARIE HEXIMER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21253 W GROVE DR
ZACHARY LA
70791-7026
US

IV. Provider business mailing address

21253 W GROVE DR
ZACHARY LA
70791-7026
US

V. Phone/Fax

Practice location:
  • Phone: 504-407-7112
  • Fax:
Mailing address:
  • Phone: 504-407-7112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number213101
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: