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

Raven Celeste Boatman, PTA

Individual provider Physical Therapy Assistant · NPI 1134701642

Raven Celeste Boatman, PTA is a Physical Therapy Assistant in Grenada, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2021
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

See every abbreviation used in this directory →

Practice location Address checks out

1966 F S Hill Dr
Grenada, MS 38901-5047
Phone: (662) 226-2442
Show map & directions

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

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence PTA6380 (MS)

Record details

NPI number1134701642
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedApril 23, 2021
Last updated in NPPESApril 23, 2021
Certification dateApril 23, 2021

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