Provider Demographics
NPI:1063238939
Name:CACERES JIMENEZ, ESTEFANY (FNP-C)
Entity type:Individual
Prefix:
First Name:ESTEFANY
Middle Name:
Last Name:CACERES JIMENEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 MADISON GDNS
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-2820
Mailing Address - Country:US
Mailing Address - Phone:848-466-5799
Mailing Address - Fax:
Practice Address - Street 1:1024 PARK AVE STE 6A
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07060-3015
Practice Address - Country:US
Practice Address - Phone:908-222-8400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15201000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily