Elaine Becker Stack, ANP-BC,ACNP-BC, CCNS

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

R60088 Issued in NM

Practice address

1101 Medical Arts Ave NE
Building 4 Suite a
Albuquerque, NM 87102-2706

Phone

(505) 272-2273

Fax

(505) 272-2075

NPI assigned

Jul 6, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1881892271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 BRADBURY DR SE",
            "address_2": "SUITE 2222",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871064374",
            "telephone_number": "505-272-3120",
            "fax_number": "505-272-8060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 MEDICAL ARTS AVE NE",
            "address_2": "BUILDING 4 SUITE A",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871022706",
            "telephone_number": "505-272-2273",
            "fax_number": "505-272-2075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STACK",
        "first_name": "ELAINE",
        "middle_name": "BECKER",
        "credential": "ANP-BC,ACNP-BC, CCNS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-06",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "NM",
            "license": "R60088",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NM",
            "license": "R60088",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey Montano DDS LLC
• Tanya M Stachowiak, PHARMD
• Sara Katherine Stachura, DPM
• Stephanie M Stachura, RN
• Amy Beth Stack, LMHC
• Lara Perea Stackonis
• Maria Elena Joy Stacy
• Holly Z Stafford, NP-C
• Jennifer Stafford
• Kristina Maria Stafford, CPSW

• Acute Care Nurse Practitioner in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Acute Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.