NPI 1023214566

Kimberly Joy Waack, PAC

Practitioner Physician Assistant Albuquerque, NM

Practice location

Address: 1901 Juan Tabo Blvd NE STE B, Albuquerque, NM 87112-3303
Phone: (505) 281-5180
Fax: (505) 702-8171
Mailing address: PO Box 602195, Charlotte, NC 28260-2195

Registered specialties (2)

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence PA2026-0045 (NM)

Other Physician Assistant providers in New Mexico →

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 0010-00955 (NC)

Registry record

NPI: 1023214566
Entity type: Individual
Sex (as registered): Female
NPI issued: 22 Jun 2007
Record last updated: 26 May 2026

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.