MEDICARE: COURTNEY L JUDE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1821949173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COURTNEY L JUDE

Provider Business Mailing Address
First Line	:	PO BOX 20112
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25362-1112
Country	:	US
Telephone Number	:	304-929-2670
Fax Number	:	304-929-2670

Provider Business Practice Location Address
First Line	:	130 GEORGE ST STE J
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-2648
Country	:	US
Telephone Number	:	304-929-2670
Fax Number	:	304-573-6862

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/04/2026
Last Update Date	:	02/04/2026

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Directions to “ COURTNEY L JUDE ” Practice Location

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