Healthcare Provider Details

I. General information

NPI: 1942126990
Provider Name (Legal Business Name): TRISTAN DAVIDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 ROBERT ROSE DR
MURFREESBORO TN
37129-6347
US

IV. Provider business mailing address

275 ROBERT ROSE DR
MURFREESBORO TN
37129-6347
US

V. Phone/Fax

Practice location:
  • Phone: 615-295-8272
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: