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NPI Code Detail

MEDICARE: REGINA LYNN BROYLES LPN

MEDICARE: REGINA LYNN BROYLES LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse189701TX

General Provider Information

NPI Number : 1518826122
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGINA LYNN BROYLES LPN
Provider Business Mailing Address
First Line : 2347 ROSSVILLE BLVD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37408-2250
Country : US
Telephone Number : 423-265-3122
Fax Number :
Provider Business Practice Location Address
First Line : 2347 ROSSVILLE BLVD
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37408-2250
Country : US
Telephone Number : 423-265-3122
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2026
Last Update Date : 01/20/2026

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