Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Bethany Lynn Stack, PA

Individual provider Medical Physician Assistant · NPI 1184619876

Bethany Lynn Stack, PA is a Physician Assistant in Rutland, Vermont. Qualified in 2003, 23 years ago. Practices with Rutland Hospital, Inc, a 186-clinician group and accepts Medicare assignment. Licensed in Vermont.

Years since qualifying
23
Licensed in
VT
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

3 Albert Cree Dr
Rutland, VT 05701-4601
Phone: (802) 775-2937
Fax: (802) 773-0934
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 055-0030670 (VT)

Record details

NPI number1184619876
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedSeptember 19, 2005
Last updated in NPPESMarch 3, 2011
Mailing address3 Albert Cree Dr, Rutland, VT 05701-4601

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2003 (23 years in practice)
Group practice Rutland Hospital, Inc. — 186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Rutland