Ms Kimberly Marie Stack, PMHNP-BC is a
Clinical Nurse Specialist - Psychiatric/mental Health, Child & Family based in Clifton Park, New York. Ms Kimberly Marie Stack is licensed to practice in New York (license number F402216) and her current practice location is
954 Route 146 Ste 3, Clifton Park, New York. She can be reached at her office (for appointments etc.) via phone at
(518) 952-4000.
NPI number for Ms Kimberly Marie Stack is 1366413536 and her current mailing address is 954 Route 146 Ste 3, Clifton Park, New York. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1366413536.
Provider's Profile
| Full Name | Ms Kimberly Marie Stack |
|---|
| Gender | Female |
|---|
| Speciality | Clinical Nurse Specialist - Psychiatric/mental Health, Child & Family |
|---|
| Location | 954 Route 146 Ste 3, Clifton Park, New York |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1366413536
- Provider Enumeration Date: 01/27/2006
- Last Update Date: 08/19/2024
Medical Identifiers
Medical identifiers for Ms Kimberly Marie Stack such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1366413536 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363L00000X | Nurse Practitioner | F402216 (New York) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 0001125389 (Virginia) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 426056-1 (New York) | Secondary |
| 364SP0810X | Clinical Nurse Specialist - Psychiatric/mental Health, Child & Family | F402216 (New York) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Kimberly Marie Stack is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ms Kimberly Marie Stack, PMHNP-BC
954 Route 146 Ste 3,
Clifton Park, NY 12065-3639
Ph: (518) 952-4000 | Ms Kimberly Marie Stack, PMHNP-BC
954 Route 146 Ste 3,
Clifton Park, NY 12065-3639
Ph: (518) 952-4000 |
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