=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275475949
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MICHALLA STUDER CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/09/2026
-----------------------------------------------------
Last Update Date | 04/09/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 313 E LIBERTY ST
-----------------------------------------------------
City | WOOSTER
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44691-4311
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-464-3078
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5729 MUD LAKE RD
-----------------------------------------------------
City | SEVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44273-9524
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | AGNP.CNP.0039636
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------