Individual
BRENDA M STOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6668 FOURTH SECTION RD, BROCKPORT, NY 14420-2448
(585) 368-6870
(585) 368-6871
Mailing address
100 KINGS HWY S, ROCHESTER, NY 14617-5504
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005069
NY
363AM0700X
Medical Physician Assistant
005069
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03081963
—
NY
Enumeration date
03/08/2006
Last updated
02/05/2026
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