Individual provider Active NPI

Kimberly Bruenn

  • Family Nurse Practitioner
  • Greenwich, CT
National Provider Identifier
1104750561
Registry record updated Jun 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
17617 Issued in CT
Practice address
43 Greenwich Ave
Greenwich, CT 06830-5510
Phone
(203) 489-3118
NPI assigned
Jun 10, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 17617 CT Primary

Addresses

Primary practice location

43 Greenwich Ave
Greenwich, CT 06830-5510

Mailing address

26 Gail CT
Carmel, NY 10512-3826

Other practice location 1

1018 High Ridge Rd
Stamford, CT 06905-1605
Phone (203) 973-7829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1781049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781049600000",
    "number": "1104750561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 GAIL CT",
            "city": "CARMEL",
            "state": "NY",
            "postal_code": "105123826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 GREENWICH AVE",
            "city": "GREENWICH",
            "state": "CT",
            "postal_code": "068305510",
            "telephone_number": "203-489-3118"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1018 High Ridge Rd",
            "address_purpose": "LOCATION",
            "city": "Stamford",
            "state": "CT",
            "postal_code": "069051605",
            "country_code": "US",
            "telephone_number": "203-973-7829",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRUENN",
        "first_name": "KIMBERLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-10",
        "last_updated": "2026-06-10",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "17617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.