MS. KIMBERLY MARIE STACK PMHNP-BC NPI 1366413536

NPI Information

NPI: 1366413536
Provider Name: MS. KIMBERLY MARIE STACK, PMHNP-BC
Classification: Clinical Nurse Specialist - 364SP0810X
Entity Type: Individual

Specialization: Psychiatric/Mental Health, Child & Family

PECOS Registration: Yes

Address:
1758 UNION ST
SCHENECTADY, NY
ZIP 12309
Phone: (518) 982-1274
Get Directions

MS. Kimberly Marie Stack, PMHNP-BC is a psychiatric/mental health and child and family clinical nurse specialist in Schenectady, 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:

1758 UNION ST
SCHENECTADY, NY
ZIP 12309-314
Phone: (518) 982-1274
Fax: (518) 982-1277

The NPI 1366413536 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Power Mobility Devices.

The enumeration date for this NPI number is 1/27/2006 and was last updated on 11/3/2017.

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
1	363L00000X	Nurse Practitioner		F402216	NEW YORK	No
2	364SP0810X	Clinical Nurse Specialist	Psychiatric/Mental Health, Child & Family	F402216	NEW YORK	Yes
3	367500000X	Nurse Anesthetist, Certified Registered		426056-1	NEW YORK	No
4	367500000X	Nurse Anesthetist, Certified Registered		0001125389	VIRGINIA	No

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: 4/28/2024

NPI Synchronization or Removal

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