# SHANNON BRUEY PMHMP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093610339
- **Authorized official:** SHANNON BRUEY PMHNP-BC, APRN-CNP (SOLE MEMBER)
- **Authorized official phone:** (405) 984-4802

## Contact information

- **Practice address:** 1750 W LAKEVIEW RD, STILLWATER, OK 74075-2746
- **Practice address phone:** (405) 984-4802
- **Practice address fax:** (405) 984-4819
- **Mailing address:** 1750 W LAKEVIEW RD, STILLWATER, OK 74075-2746
- **Mailing address phone:** (405) 984-4802
- **Mailing address fax:** (405) 984-4819

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |

## Other

- **Enumeration date:** 10/08/2026
- **Last updated:** 10/08/2026