Valerie J Bruderly, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

71000523A Issued in IN

Practice address

2210 Jackson St
Anderson, IN 46016-4363

Phone

(765) 683-3118

NPI assigned

Jul 22, 2005

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 identifiers 1

Other names 1

• Valerie J Treacy Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1992705792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8840 COMMERCE PARK PL STE E",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462683129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 JACKSON ST",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460164363",
            "telephone_number": "765-683-3118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDERLY",
        "first_name": "VALERIE",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IN",
            "license": "71000523A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200263510",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VALERIE",
            "last_name": "TREACY",
            "middle_name": "J",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jacqueline Brown
• Keisha Nicole Brown, RBT
• Stephanie Joy Brown, PHARMD
• Taylor Brown
• Emily Bruckman
• Jacob Brumfield
• Amy Buck-Boyer, BCBA
• Craig E Buckles, MD
• Matthew Robinson Buckley, PHARMD
• Jarrad Buckner

• Psychiatric/Mental Health Nurse Practitioner in Anderson, IN
• Providers in Anderson, IN by specialty
• Psychiatric/Mental Health Nurse Practitioner in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; 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.