Individual provider · Type 1 NPI

Thara L. Guillory

Gerontology Nurse Practitioner · Avenel, NJ

NPI number 1083581490 Active

Practice location

1300 Station Dr Apt 1303
Avenel, NJ 07001-1869

Call (386) 868-9658 Map

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner 363LA2200XN10571 (NY)
Adult Health Nurse Practitioner 363LA2200XRN9573108 (FL)
Registered Nurse First Assistant 163WR0006XRN9573108 (FL)
Gerontology Nurse Practitioner Primary 363LG0600X26NJ15465900 (NJ)

Gerontology Nurse Practitioner: Definition to come...

About NPI 1083581490

Thara L. Guillory's National Provider Identifier is 1083581490, issued on Oct 21, 2025. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Avenel, NJ. The record was last updated on Aug 25, 2026.