Healthcare Provider Details

I. General information

NPI: 1356282719
Provider Name (Legal Business Name): JAYSHREEBEN THUMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1007 WALKER AVE
GREENSBORO NC
27403
US

IV. Provider business mailing address

1007 WALKER AVE
GREENSBORO NC
27403
US

V. Phone/Fax

Practice location:
  • Phone: 336-334-5400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5025117
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: