Traci R Doutre, NBC-HWC

Primary specialty

Health & Wellness CoachTaxonomy code 171400000X

License

A-3635420 Issued in MO

Practice address

1 Jefferson Barracks Rd
Whole Health Department
St Louis, MO 63125

Phone

(314) 652-4100

NPI assigned

Sep 22, 2023

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Traci R Lyerla Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695340800000",
    "number": "1144009879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS RD",
            "address_2": "WHOLE HEALTH DEPARTMENT",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63125",
            "telephone_number": "314-652-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JEFFERSON BARRACKS RD",
            "address_2": "WHOLE HEALTH DEPARTMENT",
            "city": "ST LOUIS",
            "state": "MO",
            "postal_code": "63125",
            "telephone_number": "314-652-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUTRE",
        "first_name": "TRACI",
        "middle_name": "R",
        "credential": "NBC-HWC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-22",
        "last_updated": "2023-09-22",
        "certification_date": "2023-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": "MO",
            "license": "A-3635420",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACI",
            "last_name": "LYERLA",
            "middle_name": "R",
            "credential": "NBC-HWC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Health & Wellness Coach in St Louis, MO
• Providers in St Louis, MO by specialty
• Health & Wellness Coach in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.