Individual provider · Type 1 NPI
Kimberly Marie Stack, PMHNP-BC
Psychiatric/Mental Health Nurse Practitioner · Clifton Park, NY
NPI number
1366413536
Active
Practice location
954 Route 146 Ste 3
Clifton Park, NY 12065-3639
Fax (833) 974-2234
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner | 363L00000X | F402216 (NY) |
| Certified Registered Nurse Anesthetist | 367500000X | 0001125389 (VA) |
| Certified Registered Nurse Anesthetist | 367500000X | 426056-1 (NY) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 402216 (NY) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
2 other providers at this address
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About NPI 1366413536
Kimberly Marie Stack, PMHNP-BC's National Provider Identifier is 1366413536, issued on Jan 27, 2006. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Clifton Park, NY. The record was last updated on Jun 2, 2025.