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
Mailing address1818 Sw Leslie Gln, Lake City, FL 32025-1406

Other providers in Lake City