Provider Demographics
NPI:1437245792
Name:COLSTON, JAMEY K (FNP)
Entity type:Individual
Prefix:
First Name:JAMEY
Middle Name:K
Last Name:COLSTON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 WOODBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38068-1242
Mailing Address - Country:US
Mailing Address - Phone:901-465-6353
Mailing Address - Fax:833-902-3599
Practice Address - Street 1:25 WOODBRIDGE RD
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:TN
Practice Address - Zip Code:38068-1242
Practice Address - Country:US
Practice Address - Phone:901-465-6353
Practice Address - Fax:833-902-3599
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2025-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5859363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4264387OtherBLUE CROSS
TN3022250Medicaid
TN9656279OtherCIGNA COMMERCIAL
TNPE-59634OtherPECOS
TN3644575Medicaid
TN4108029OtherBLUE CROSS GROUP
TN4264387OtherBLUE CROSS
TN3644575Medicare PIN
TN4108029OtherBLUE CROSS GROUP