Individual
KELLY JEANNE KNICKERBOCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1415 PORTLAND AVE STE 400, ROCHESTER, NY 14621-3022
(585) 922-4200
(585) 922-4922
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
002473
NY
176B00000X
Midwife
Primary
—
—
Other
Enumeration date
12/29/2025
Last updated
03/23/2026
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