MS. KIMBERLY MARIE STACK PMHNP-BC NPI 1366413536

NPI Information

  • NPI: 1366413536
  • Provider Name: MS. KIMBERLY MARIE STACK, PMHNP-BC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Individual
  • Address: 954 ROUTE 146 STE 3
    CLIFTON PARK, NY
    ZIP 12065
  • Phone: (518) 952-4000

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NPI Details

MS. Kimberly Marie Stack, PMHNP-BC is a psychiatric/mental health nurse practitioner in Clifton Park, NY. MS. Kimberly Marie Stack, PMHNP-BC NPI is 1366413536. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

954 ROUTE 146 STE 3
CLIFTON PARK, NY
ZIP 12065-639
Phone: (518) 952-4000
Fax: (833) 974-2234

The enumeration date for this NPI number is 1/27/2006 and was last updated on 6/2/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363L00000XNurse PractitionerF402216NEW YORKNo
2367500000XNurse Anesthetist, Certified Registered0001125389VIRGINIANo
3367500000XNurse Anesthetist, Certified Registered426056-1NEW YORKNo
4363LP0808XNurse PractitionerPsychiatric/Mental Health402216NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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