Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly S. Wallach, PA-C

Individual provider Medical Physician Assistant · NPI 1750391462

Kimberly S. Wallach, PA-C is a Medical Physician Assistant in Prescott Valley, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6496 E State Route 69
Prescott Valley, AZ 86314-2920
Phone: (928) 775-9007
Fax: (928) 775-9048
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 5775 (AZ)

Record details

NPI number1750391462
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 8, 2006
Last updated in NPPESSeptember 9, 2014

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