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

Timothy Kyle Stacks, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1447224936

Timothy Kyle Stacks, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Camp Lejeune, North Carolina. Qualified in 2004, 22 years ago. Practices with Medstream Anesthesia PLLC, a 577-clinician group and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
22
Licensed in
NC
In the registry since
2006
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

100 Brewster Blvd Naval Hospital Camp Lejeune
Camp Lejeune, NC 28547-2538
Phone: (910) 450-4791
Show map & directions

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

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 149855 (NC)

Record details

NPI number1447224936
Entity typeIndividual (Type 1)
GenderMale
Credentials CRNA
Sole proprietorNo
NPI enumeratedFebruary 14, 2006
Last updated in NPPESJuly 13, 2026

Medicare enrollment

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

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Medstream Anesthesia Pllc — 577 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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