Provider Demographics
NPI:1932533866
Name:SCHEXNAYDRE, STACEY RAZIANO (PD)
Entity Type:Individual
Prefix:MRS
First Name:STACEY
Middle Name:RAZIANO
Last Name:SCHEXNAYDRE
Suffix:
Gender:F
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12589 AIRLINE HWY
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-2501
Mailing Address - Country:US
Mailing Address - Phone:985-764-1158
Mailing Address - Fax:985-764-3142
Practice Address - Street 1:12589 AIRLINE HWY
Practice Address - Street 2:
Practice Address - City:DESTREHAN
Practice Address - State:LA
Practice Address - Zip Code:70047-2501
Practice Address - Country:US
Practice Address - Phone:985-764-1158
Practice Address - Fax:985-764-3142
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-28
Last Update Date:2013-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15367183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist