Organization Active NPI

Shannon Bruey Pmhmp LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Stillwater, OK
National Provider Identifier
1093610339
Registry record updated Oct 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
SHANNON BRUEY PMHMP LLC
Practice address
1750 W Lakeview Rd
Stillwater, OK 74075-2746
Phone
(405) 984-4802
Fax
(405) 984-4819
NPI assigned
Oct 8, 2026
Last updated
Oct 8, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2026

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

Authorized official

Name
Shannon Bruey, PMHNP-BC, APRN-CNP
Title
Sole Member
Phone
(405) 984-4802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

1750 W Lakeview Rd
Stillwater, OK 74075-2746

Mailing address

1750 W Lakeview Rd
Stillwater, OK 74075-2746
Phone (405) 984-4802

NPI Registry JSON

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

{
    "created_epoch": "1791417600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791417600000",
    "number": "1093610339",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 W LAKEVIEW RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740752746",
            "telephone_number": "405-984-4802",
            "fax_number": "405-984-4819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 W LAKEVIEW RD",
            "city": "STILLWATER",
            "state": "OK",
            "postal_code": "740752746",
            "telephone_number": "405-984-4802",
            "fax_number": "405-984-4819"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON BRUEY PMHMP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-08",
        "last_updated": "2026-10-08",
        "certification_date": "2026-10-08",
        "status": "A",
        "authorized_official_last_name": "BRUEY",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "405-984-4802",
        "authorized_official_credential": "PMHNP-BC, APRN-CNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stillwater, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.