Healthcare Provider Details

I. General information

NPI: 1063414621
Provider Name (Legal Business Name): BARBARA FRANCES STACK PCCHNP, FNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2005
Last Update Date: 07/13/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 OLD FORGE HILL RD VAILS GATE ELEMENTARY SCHOOL HEALTH OFFICE
NEW WINDSOR NY
12553-8549
US

IV. Provider business mailing address

PO BOX 56
BLOOMING GROVE NY
10914-0056
US

V. Phone/Fax

Practice location:
  • Phone: 845-563-7911
  • Fax: 845-563-7905
Mailing address:
  • Phone: 845-496-7019
  • Fax: 845-496-7825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberF320014
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number208206
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: