Provider Demographics
NPI:1225345820
Name:CABALLERO JIMENEZ, TANIA ISABEL (BCSN,MSN, ACNP- BC)
Entity type:Individual
Prefix:MS
First Name:TANIA
Middle Name:ISABEL
Last Name:CABALLERO JIMENEZ
Suffix:
Gender:F
Credentials:BCSN,MSN, ACNP- BC
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Mailing Address - Street 1:1 FORD PL STE 3A
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3450
Mailing Address - Country:US
Mailing Address - Phone:800-999-5829
Mailing Address - Fax:313-876-1305
Practice Address - Street 1:19675 ALLEN RD
Practice Address - Street 2:
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-1021
Practice Address - Country:US
Practice Address - Phone:734-479-3311
Practice Address - Fax:734-479-8009
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-03
Last Update Date:2025-11-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4704247441363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care