Individual provider Active NPI

Tylicia L Grant

  • Nurse's Aide
  • Omaha, NE
National Provider Identifier
1205749793
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse's AideTaxonomy code 376K00000X
Practice address
1402 Jones St # 245
Omaha, NE 68102-3218
Phone
(402) 452-9339
NPI assigned
Sep 24, 2026
Last updated
Sep 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse's Aide 376K00000X NU Primary

Addresses

Primary practice location

1402 Jones St # 245
Omaha, NE 68102-3218

Mailing address

1402 Jones St # 245
Omaha, NE 68102-3218
Phone (402) 452-9339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1205749793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1402 JONES ST # 245",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681023218",
            "telephone_number": "402-452-9339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 JONES ST # 245",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681023218",
            "telephone_number": "402-452-9339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRANT",
        "first_name": "TYLICIA",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.