Licensure follows the patient
The location that matters for telehealth is generally the patient’s, not yours. Sitting in one state and caring for a patient in West Virginia generally means you need authority to practice in West Virginia — via compact privilege or a West Virginia license. See telehealth: patient in another state.
The law that governs this in West Virginia
Caring for a patient located in West Virginia is practice in West Virginia, so it is West Virginia’s own nurse practice act that defines what you may do and the West Virginia RN Board / LPN Board that applies it. That act is W. Va. Code art. 30-7 (registered nurses); art. 30-7A (licensed practical nurses).
The compact itself is separate law. West Virginia adopted it at W. Va. Code art. 30-7F (Nurse Licensure Compact), which is what allows a multistate license issued elsewhere to reach West Virginia at all — the practice act still decides what you may do once it does.
Compact status is not the only consideration
Even where a multistate license reaches West Virginia, your employer and the West Virginia RN Board / LPN Board may impose additional requirements, and some roles carry their own rules. Compact status answers one question — it is not a blanket authorization to practice remotely.
APRN telehealth is separate
The compact covers RN and LPN/LVN licenses only. If you work as an APRN, your advanced-practice authority is granted state by state and is not carried by a multistate RN license — a point that catches out a lot of remote NP roles.
Since when has a compact license worked in West Virginia?
Nurses holding another state’s multistate license have been able to practice in West Virginia since January 19, 2018. It has been a member long enough that most guidance you find will be accurate on this point.