Organization
BRIGETTE'S TECHNOLOGY CONSULTING AND RESEARCH FIRM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. BRENDA LYNN NELSON-PORTER ND (RESEARCHER/CLIA-WAIVED LABORATORY)
(770) 365-7577
Entity
Organization
Contact information
Practice address
105 WILSON CIR, NEWNAN, GA 30263-5594
(770) 365-7577
(770) 251-6765
Mailing address
105 WILSON CIR, NEWNAN, GA 30263-5594
(770) 365-7577
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
261QC1500X
Community Health Clinic/Center
—
—
261QG0250X
Genetics Clinic/Center
—
—
293D00000X
Physiological Laboratory
Primary
—
—
385H00000X
Respite Care
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11D2201618
CMS
GA
01
—
1417557638
NPPES
GA
Enumeration date
07/22/2021
Last updated
07/22/2021
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