MEDICARE: MRS. STEPHANIE MICHELLE SUDOL MSN, APRN, CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	176B00000X	Midwife	002445	NY

General Provider Information

NPI Number	:	1588526776
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. STEPHANIE MICHELLE SUDOL MSN, APRN, CNM

Provider Business Mailing Address
First Line	:	100 KINGS HWY S
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14617-5504
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	995 SENATOR KEATING BLVD STE 210
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2776
Country	:	US
Telephone Number	:	585-368-4455
Fax Number	:	585-271-3688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/26/2025
Last Update Date	:	01/21/2026

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