Mary Bruen, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MED-PAC-LIC-60161 Issued in MT

Practice address

601 W Spruce St Ste J
Missoula, MT 59802

Phone

(406) 327-3350

Fax

(406) 327-3355

NPI assigned

May 18, 2016

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

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1463529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526256000000",
    "number": "1407203680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 W SPRUCE ST STE J",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598024047",
            "telephone_number": "406-327-3350",
            "fax_number": "406-549-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W SPRUCE ST STE J",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "59802",
            "telephone_number": "406-327-3350",
            "fax_number": "406-327-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUEN",
        "first_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-18",
        "last_updated": "2018-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MT",
            "license": "MED-PAC-LIC-60161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy E Brown, CMT
• Julie P Browne, RT
• Clare Brownlee, MD
• Marcia Brownlee, PCLC
• Katrina Lin Brucker, NP
• Chelci Marie Bruno
• Cody Bryant, LCPC
• Maureen Bryant, LCSW
• Mariel Kareen Bryden, MD
• Chloe Bryson, MS, CCC-SLP

• Physician Assistant in Missoula, MT
• Providers in Missoula, MT by specialty
• Physician Assistant in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.