Marianne Teresa Bruyere, RN

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

490645 Issued in NY

Practice address

1 Chimney Point Dr
Ogdensburg, NY 13669-2212

Phone

(315) 541-2001

Fax

(315) 541-2089

NPI assigned

Apr 13, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Marianne Teresa Fennessy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271116800000",
    "number": "1114243318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692212",
            "telephone_number": "315-541-2001",
            "fax_number": "315-541-2089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 CHIMNEY POINT DR",
            "city": "OGDENSBURG",
            "state": "NY",
            "postal_code": "136692212",
            "telephone_number": "315-541-2001",
            "fax_number": "315-541-2089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUYERE",
        "first_name": "MARIANNE",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2010-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "NY",
            "license": "490645",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANNE",
            "last_name": "FENNESSY",
            "middle_name": "TERESA",
            "prefix": "MRS.",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ryan Beth Brooks
• Colin Roy Brotherton, REGISTERED NURSE
• Kristin W Brown, LCSW
• Thelma L. Brown
• Grace Eileen Brunelle, RN
• Kenneth I. Brydges, DO
• Stephen Buddenhagen
• Adam D Bullock
• Leroy W Burger, CASAC
• Emily Burgess

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Ogdensburg, NY
• Providers in Ogdensburg, NY by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; 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.