Provider Demographics
NPI:1487227997
Name:BRIGETTE'S TECHNOLOGY CONSULTING AND RESEARCH FIRM
Entity Type:Organization
Organization Name:BRIGETTE'S TECHNOLOGY CONSULTING AND RESEARCH FIRM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESEARCHER/CLIA-WAIVED LABORATORY
Authorized Official - Prefix:PROF
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:NELSON-PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:770-365-7577
Mailing Address - Street 1:105 WILSON CIR
Mailing Address - Street 2:
Mailing Address - City:NEWNAN
Mailing Address - State:GA
Mailing Address - Zip Code:30263-5594
Mailing Address - Country:US
Mailing Address - Phone:770-365-7577
Mailing Address - Fax:
Practice Address - Street 1:105 WILSON CIR
Practice Address - Street 2:
Practice Address - City:NEWNAN
Practice Address - State:GA
Practice Address - Zip Code:30263-5594
Practice Address - Country:US
Practice Address - Phone:770-365-7577
Practice Address - Fax:770-251-6765
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes293D00000XLaboratoriesPhysiological Laboratory
No251E00000XAgenciesHome Health
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
No261QG0250XAmbulatory Health Care FacilitiesClinic/CenterGenetics
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1417557638OtherNPPES
GA11D2201618OtherCMS