Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Thara L Guillory

Individual provider Registered Nurse First Assistant · NPI 1083581490

Thara L Guillory is a Nurse Practitioner in Avenel, New Jersey. Qualified in 2025, 1 year ago. Licensed in Florida and New York.

Years since qualifying
1
Licensed in
FL, NY
In the registry since
2025
Specialties on file
3

Practice location Address checks out

1300 Station Dr Apt 1303
Avenel, NJ 07001-1869
Phone: (386) 868-9658
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence RN9573108 (FL)
Registered Nurse First Assistant Taxonomy 163WR0006X · Licence RN9573108 (FL)
Adult Health Nurse Practitioner Taxonomy 363LA2200X · Licence N10571 (NY)

Record details

NPI number1083581490
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 21, 2025
Last updated in NPPESOctober 21, 2025
Certification dateOctober 21, 2025
Mailing address1300 Station Dr Apt 1303, Avenel, NJ 07001-1869

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Avenel