Rebecca Broderick, ACNPC-AG, BSN, RN
NPI 1629755657ActiveIndividual· Nurse Practitioner· Lacey, WA
Nurse Practitioner (ACNPC-AG, BSN, RN) with Providence Health and Services Washington, practicing in Lacey, Washington. Medicare paid $2,808 for services to 20 patients in 2024. Lists Providence St Peter Hospital as a hospital affiliation.
Overview
| NPI | 1629755657 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | ACNPC-AG, BSN, RN |
| Sole proprietor | Yes |
| NPI issued | Jun 30, 2023 |
| Last updated in NPPES | Jun 30, 2023 |
| Certified by provider | Jun 30, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 61413663-NP | WA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (WA) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 20 |
|---|---|
| Services billed | 41 across 6 procedure codes |
| Paid by Medicare | $2,808 |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Providence Health and Services WashingtonOlympia, WA · 14 clinicians
Hospital affiliation
- Providence St Peter HospitalOlympia, WA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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