Provider Demographics
NPI:1477537066
Name:SCHEXNYDER, JACQUELINE ANN (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:ANN
Last Name:SCHEXNYDER
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 124
Mailing Address - Street 2:
Mailing Address - City:LECOMPTE
Mailing Address - State:LA
Mailing Address - Zip Code:71346-0124
Mailing Address - Country:US
Mailing Address - Phone:318-729-6003
Mailing Address - Fax:318-483-5117
Practice Address - Street 1:2810 HIGHWAY 72 S
Practice Address - Street 2:
Practice Address - City:LECOMPTE
Practice Address - State:LA
Practice Address - Zip Code:71360-7134
Practice Address - Country:US
Practice Address - Phone:318-466-2105
Practice Address - Fax:318-483-5117
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP04075363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1128155Medicaid
LA662OtherNURSE PRACTITIONER ADULT HEALTH
P61684Medicare UPIN
LA4C2757549Medicare PIN