Kimberly Broyles, RN

Individual provider Active NPI Registered Nurse · Brighton, IL

NPI 1336078427 · NPPES record last updated May 15, 2026

Key facts

NPI
1336078427
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
041469378 (IL)
Practice address
305 Avalon St
Brighton, IL 62012-1319
Phone
(314) 795-4436
NPI assigned
May 15, 2026
Sex
Female
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041469378ILMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041469378 IL Yes

Addresses

Primary practice location

305 Avalon St
Brighton, IL 62012-1319

Mailing address

305 Avalon St
Brighton, IL 62012-1319
Phone (314) 795-4436

Other providers in Brighton, IL

All providers in Brighton, IL · Registered Nurse in Illinois

Sources for this page

Verify at the official NPI Registry.