Jackson, Raven

Jackson, Raven is an individual health care provider with primary practice located at 1818 Sw Leslie Gln , Lake City FL 32025-1406. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Driver, Nursing Service Related Providers / Personal Care Attendant. Nursing Service Related Providers / Personal Care Attendant is her primary health care specialty. Jackson, Raven can be contacted via phone (386) 406-7236.

Contact Information

Primary practice address
1818 Sw Leslie Gln Lake City FL 32025-1406
Phone: (386) 406-7236
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Driver 172A00000X J250-732-83-834-0 Florida
Nursing Service Related Providers / Personal Care Attendant 3747P1801X CNA-18322 Florida

Profile Details

NPI number 1972496347
LBN Legal business name Jackson, Raven
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2025
Last updated Jun 2nd, 2025 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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