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Individual

KIMBERLY DIANE HILDITCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4390
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
161706
ASH
AZ
01
2Z2293
HEALTH NET
AZ
01
326111
MEDICAID
AZ
01
326111
AHCCCS
01
4428261
AETNA
AZ
01
719049
AHCCCS
AZ
01
P00121650
RAILROAD MEDICARE
AZ
01
P02039084
RAILROAD MEDICARE
AZ
Enumeration date
03/01/2006
Last updated
01/07/2025
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