Provider Demographics
NPI:1831663616
Name:WEST, COURTNEY NICOLE (DOULA, LPN, CBE, CLE)
Entity Type:Individual
Prefix:
First Name:COURTNEY
Middle Name:NICOLE
Last Name:WEST
Suffix:
Gender:F
Credentials:DOULA, LPN, CBE, CLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2335 22ND AVE S
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33712-3019
Mailing Address - Country:US
Mailing Address - Phone:727-231-4670
Mailing Address - Fax:
Practice Address - Street 1:2335 22ND AVE S # 4
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33712
Practice Address - Country:US
Practice Address - Phone:727-231-4670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
FL172V00000X, 374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator
No172V00000XOther Service ProvidersCommunity Health Worker