Provider Demographics
NPI:1194615906
Name:JACKSON, SCHENIQUE L (RN, CPC, CRC)
Entity type:Individual
Prefix:
First Name:SCHENIQUE
Middle Name:L
Last Name:JACKSON
Suffix:
Gender:F
Credentials:RN, CPC, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25535 BALSAMROOT DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77355-4379
Mailing Address - Country:US
Mailing Address - Phone:713-548-6630
Mailing Address - Fax:
Practice Address - Street 1:25535 BALSAMROOT DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77355-4379
Practice Address - Country:US
Practice Address - Phone:713-548-6630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-04
Last Update Date:2025-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX844864163WC1500X, 163WP0807X, 163W00000X
TX84464163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult