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

Jalicia Grant, FNP-BC

Individual provider Registered Nurse · NPI 1790173953

Jalicia Grant, FNP-BC is a Nurse Practitioner in East Orange, New Jersey. Qualified in 2022, 4 years ago. Practices with Ennoble Hc Nj PC, a 127-clinician group and accepts Medicare assignment. Licensed in New Jersey.

Years since qualifying
4
Licensed in
NJ
In the registry since
2014
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

15 Wayne Ave
East Orange, NJ 07018-1907
Phone: (914) 490-5941
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ14886900 (NJ)
Registered Nurse Taxonomy 163W00000X · Licence 26NR23060600 (NJ)

Record details

NPI number1790173953
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedDecember 22, 2014
Last updated in NPPESSeptember 29, 2023
Certification dateSeptember 29, 2023

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Ennoble Hc Nj Pc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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