Provider Demographics
NPI:1497399919
Name:BRIGMAN, AMY DIANE (FNP-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:DIANE
Last Name:BRIGMAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 TURTLE DOVE CT
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6416
Mailing Address - Country:US
Mailing Address - Phone:478-321-7317
Mailing Address - Fax:478-633-5183
Practice Address - Street 1:618 ORANGE ST
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-2081
Practice Address - Country:US
Practice Address - Phone:478-633-9079
Practice Address - Fax:478-633-5183
Is Sole Proprietor?:No
Enumeration Date:2019-10-29
Last Update Date:2025-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5020931363LF0000X
GARN236405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GARN236405OtherNP LICENSURE
GAF08191038OtherNP CERTIFICATION NUMBER