Healthcare Provider Details

I. General information

NPI: 1417537432
Provider Name (Legal Business Name): COURTNEY JEAN NAIL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2021
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 PENNSYLVANIA AVE
CHARLESTON WV
25302-3351
US

IV. Provider business mailing address

800 PENNSYLVANIA AVE
CHARLESTON WV
25302-3351
US

V. Phone/Fax

Practice location:
  • Phone: 304-388-2427
  • Fax: 304-388-2437
Mailing address:
  • Phone: 304-388-2427
  • Fax: 304-388-2437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4657
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: