Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Gilliard Broadwell, ACNP

Individual provider Acute Care Nurse Practitioner · NPI 1255928479

Kimberly Gilliard Broadwell, ACNP is a Nurse Practitioner in Raleigh, North Carolina. Qualified in 2020, 6 years ago. Practices with North Carolina Mg LLC, a 712-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in North Carolina.

Years since qualifying
6
Licensed in
NC
In the registry since
2020
What do these letters mean?
ACNP — Acute Care Nurse Practitioner
A nurse practitioner who treats acutely ill patients, usually in hospital.

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Practice location Address checks out

4420 Lake Boone Trl
Raleigh, NC 27607-7505
Phone: (919) 784-3542
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2800 Blue Ridge Rd, Raleigh, NC 27607-6478 — (919) 787-5380

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 5013905 (NC)

Record details

NPI number1255928479
Entity typeIndividual (Type 1)
GenderFemale
Credentials ACNP
Sole proprietorNo
NPI enumeratedDecember 22, 2020
Last updated in NPPESMay 3, 2021
Certification dateMay 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice North Carolina Mg Llc — 712 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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