Healthcare Provider Details

I. General information

NPI: 1154694065
Provider Name (Legal Business Name): JEANETTE M GRANT DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JEANETTE MISSOURI SESSOMS DNP, FNP-BC

II. Dates (important events)

Enumeration Date: 02/23/2012
Last Update Date: 09/14/2023
Certification Date: 09/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21444 CARMEAN WAY
GEORGETOWN DE
19947-4572
US

IV. Provider business mailing address

100 RAWLINS DR
SEAFORD DE
19973-5881
US

V. Phone/Fax

Practice location:
  • Phone: 302-855-1233
  • Fax: 302-855-2025
Mailing address:
  • Phone: 302-990-3300
  • Fax: 302-990-3300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024169918
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0012313
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: