Provider Demographics
NPI:1316050586
Name:ROLSTON, ALLISON E (PA-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:E
Last Name:ROLSTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1605 NASHVILLE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-2071
Mailing Address - Country:US
Mailing Address - Phone:931-540-4210
Mailing Address - Fax:931-380-1202
Practice Address - Street 1:330 FRANKLIN RD STE 135-A270
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-3280
Practice Address - Country:US
Practice Address - Phone:615-274-9767
Practice Address - Fax:615-807-4811
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN790363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3710089Medicaid
TN4079244OtherBCBST
TN3669357Medicaid
TN4051915OtherBCBST
TN4051915OtherBCBST
TN4079244OtherBCBST
TNS99850Medicare UPIN
TNCE0561Medicare PIN
TN3669357Medicare PIN