Healthcare Provider Details

I. General information

NPI: 1437079167
Provider Name (Legal Business Name): LUCRETIA CHATMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1053 N HANLEY RD
SAINT LOUIS MO
63130-2105
US

IV. Provider business mailing address

1053 N HANLEY RD
SAINT LOUIS MO
63130-2105
US

V. Phone/Fax

Practice location:
  • Phone: 314-791-9582
  • Fax:
Mailing address:
  • Phone: 314-791-9582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: