Provider Demographics
NPI:1417561002
Name:COLSTON, TABRIA (FNP-C)
Entity Type:Individual
Prefix:
First Name:TABRIA
Middle Name:
Last Name:COLSTON
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 1:2386 CLOWER ST STE C105
Mailing Address - Street 2:
Mailing Address - City:SNELLVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30078-6107
Mailing Address - Country:US
Mailing Address - Phone:678-344-0344
Mailing Address - Fax:678-344-0343
Practice Address - Street 1:2386 CLOWER ST STE C105
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-6107
Practice Address - Country:US
Practice Address - Phone:678-344-0334
Practice Address - Fax:678-344-0343
Is Sole Proprietor?:No
Enumeration Date:2020-09-01
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN176249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily