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

MS. Kimberly Marie Stack, PMHNP-BC

Individual provider Nurse Practitioner · NPI 1366413536

MS. Kimberly Marie Stack, PMHNP-BC is a Nurse Practitioner in Clifton Park, New York. Practices as a sole proprietor. Licensed in New York and Virginia.

Licensed in
NY, VA
In the registry since
2006
Specialties on file
4
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

See every abbreviation used in this directory →

Practice location Address checks out

954 Route 146 Ste 3
Clifton Park, NY 12065-3639
Phone: (518) 952-4000
Fax: (833) 974-2234
Show map & directions

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

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 402216 (NY)
Nurse Practitioner Taxonomy 363L00000X · Licence F402216 (NY)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 0001125389 (VA)
Certified Registered Nurse Anesthetist Taxonomy 367500000X · Licence 426056-1 (NY)

Record details

NPI number1366413536
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorYes
NPI enumeratedJanuary 27, 2006
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025

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