Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Raven Jackson

Individual provider Driver · NPI 1972496347

Raven Jackson is a Driver in Lake City, Florida. Licensed in Florida. Registered with an NPI since 2025.

Licensed in
FL
In the registry since
2025
Specialties on file
2

Practice location Address checks out

1818 SW Leslie Gln
Lake City, FL 32025-1406
Phone: (386) 406-7236
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Personal Care Attendant (primary) Taxonomy 3747P1801X · Licence CNA-18322 (FL)
Driver Taxonomy 172A00000X · Licence J250-732-83-834-0 (FL)

Record details

NPI number1972496347
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 2, 2025
Last updated in NPPESJune 2, 2025
Certification dateJune 2, 2025

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