Provider Demographics
NPI:1255208518
Name:THOMAS, JAYLIN GEORGIA
Entity type:Individual
Prefix:
First Name:JAYLIN
Middle Name:GEORGIA
Last Name:THOMAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 SALIDA TRL
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-1685
Mailing Address - Country:US
Mailing Address - Phone:304-839-0772
Mailing Address - Fax:
Practice Address - Street 1:350 SALIDA TRL
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-1685
Practice Address - Country:US
Practice Address - Phone:304-839-0772
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-21
Last Update Date:2025-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV17156183747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant