KIMBERLY ANN WALLACH (NPI# 1881201168) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1881201168 |
Entity Type | Individual |
Full Name | KIMBERLY ANN WALLACH |
Credential | NNP-BC |
Practice Address |
4710 Montgomery Blvd Ne Albuquerque NM 87109-1220 |
Mailing Address |
3423 68th Dr Lubbock TX 79413-6121 |
Practice Telephone | 8064708876 |
Mailing Telephone | 8064708876 |
Enumeration Date | 2020-09-30 |
Last Update Date | 2020-09-30 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LN0000X |
Nurse Practitioner Specialization: Neonatal |
AP144855 | TX | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1750391462 | Kimberly S. Wallach | Physician Assistant | 6496 E State Route 69, Prescott Valley, AZ 86314-2920 | 2006-08-08 |
1023251816 | Kimberly D. Wallach | Registered Nurse | 551 Broadway, Eagle, CO 81631 | 2009-04-09 |
Street Address |
4710 MONTGOMERY BLVD NE |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87109-1220 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1386286367 | Mikaela Epaloose | Behavior Technician | 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-10-11 |
1245872464 | Marsha Director | Behavior Technician | 100 Sun Avenue Ne, Ste 650, Albuquerque, NM 87109 | 2019-10-09 |
1720637499 | Nancy Gail Vice | Technician | 7319 Laguna Niguel Drive Ne, Albuquerque, NM 87109 | 2019-09-05 |
1598314411 | Chau Vu | Behavior Technician | Attn: Behavioral Health Works 100 Sun Avenue N.e., Suite 650, Albuquerque, NM 87109 | 2019-09-04 |
1932753498 | Noelle Nielsen | Behavior Technician | 6401 Academy Rd. Ne Apt. 189, Albuquerque, NM 87109 | 2019-08-01 |
1952967952 | Caridad Merkel | Obstetrics & Gynecology | 6100 Pan American Fwy Ne Suite 450, Albuquerque, NM 87109 | 2019-05-15 |
1043795149 | Margaret Mcconville | Physical Therapist | Lovelace Women's Hospital Outpatient Rehabilitation, 4600 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-09-25 |
1922586262 | Clark Endodontics LLC | Dentist | 7520 Montgomery Blvd Ne Bldg E1, Albuquerque, NM 87109 | 2018-07-30 |
1447736202 | Melissa Christine Scott | Registered Nurse | Lovelace Women's Hospital, 4701 Montgomery Blvd Ne, Albuquerque, NM 87109 | 2018-07-16 |
1508351990 | Gianna Nicole Casarez-quintana | Dentist | 7520 Montgomery Blvd Ne Bldg E10, Albuquerque, NM 87109 | 2018-06-27 |
Find all providers in zip 87109 |
Taxonomy Code | 363LN0000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Neonatal |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235464710 | Tom Anthony Pantano | Nurse Practitioner | 715 Silver Ave Se, Albuquerque, NM 87102-3637 | 2009-10-16 |
1619434164 | Matthew Grindstaff | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2019-02-20 |
1477002962 | Jazmine Carr Valencia | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2016-09-26 |
1669869780 | Nichole Cherie Hockenberry | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106 | 2015-04-16 |
1841625852 | Alexa S Lujan | Nurse Practitioner | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2013-09-09 |
1790014876 | Angela Elizabeth Bachicha | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2745 | 2009-12-18 |
1093983462 | Courtney Grassham | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2719 | 2008-02-19 |
1851574917 | Brenda Sue Gonzales | Nurse Practitioner | 2211 Lomas Blvd Ne, Albuquerque, NM 87106-2745 | 2007-12-12 |
1184669368 | Vanessa V Casarez | Nurse Practitioner | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2006-06-19 |
1811935737 | Rosaline R Tenorio | Nurse Practitioner | 1100 Central Ave Se, Albuquerque, NM 87106-4930 | 2006-06-03 |
Find all providers in ALBUQUERQUE |
City | ALBUQUERQUE |
Zip Code | 87109 |
Please comment or provide details below to improve the information on KIMBERLY ANN WALLACH.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.