Healthcare Provider Details

I. General information

NPI: 1962397687
Provider Name (Legal Business Name): JENNIFER WARING PAA PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2025
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4443 JESSUP GROVE RD
GREENSBORO NC
27410-9934
US

IV. Provider business mailing address

402 CRESTLAND AVE
GREENSBORO NC
27401-1720
US

V. Phone/Fax

Practice location:
  • Phone: 336-663-4600
  • Fax:
Mailing address:
  • Phone: 336-392-5030
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberP10974
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number10974
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: