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

MS. Kristy Rose Broderick, FNP-BC

Individual provider Registered Nurse · NPI 1487801817

MS. Kristy Rose Broderick, FNP-BC is a Nurse Practitioner in San Diego, California. Qualified in 2009, 17 years ago. Practices with Regents of the University of California, a 2,061-clinician group, accepts Medicare assignment and offers telehealth. Licensed in California and Oregon.

Years since qualifying
17
Licensed in
CA, OR
In the registry since
2008
Specialties on file
2
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

200 W Arbor Dr Dept 8220
San Diego, CA 92103-8220
Phone: (619) 840-4432
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 19601 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 200441107RN (OR)

Record details

NPI number1487801817
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedAugust 27, 2008
Last updated in NPPESSeptember 10, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2009 (17 years in practice)
Group practice Regents Of The University Of California — 2061 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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