Healthcare Provider Details

I. General information

NPI: 1447138102
Provider Name (Legal Business Name): EXQUISITE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2025
Last Update Date: 08/21/2025
Certification Date: 08/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3751 PENNRIDGE DR STE 116C
BRIDGETON MO
63044-1244
US

IV. Provider business mailing address

3751 PENNRIDGE DR
BRIDGETON MO
63044-1242
US

V. Phone/Fax

Practice location:
  • Phone: 314-517-0351
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: COURTNEY NANCE
Title or Position: OWNER
Credential:
Phone: 314-517-0351