Individual
DR. BRENDA L NELSON-PORTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
105 WILSON CIR, NEWNAN, GA 30263-5594
(770) 365-7577
Mailing address
105 WILSON CIR, NEWNAN, GA 30263-5594
(770) 365-7577
Taxonomy
Speciality
Code
Description
License number
State
133NN1002X
Nutrition Education Nutritionist
—
—
175F00000X
Naturopath
Primary
—
—
261QG0250X
Genetics Clinic/Center
—
—
291900000X
Military Clinical Medical Laboratory
—
—
293D00000X
Physiological Laboratory
—
—
374U00000X
Home Health Aide
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
10/27/2020
Last updated
11/18/2020
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