Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
RAVEN JACKSON
ActiveRAVEN JACKSON is a Foot & Ankle Surgery healthcare provider located in LAKE CITY, Florida. NPI 1972496347 is currently active in the NPPES registry. Verify at CMS.
Foot & Ankle Surgery · LAKE CITY, FL
Registration Details
- NPI Number
- 1972496347
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jun 2, 2025 (1.2118878763673 yrs)
- Last Updated
- Jun 2, 2025
- Licenses
-
J250-732-83-834-0 (FL)CNA-18322 (FL)
Practice Information
- Address
-
1818 SW LESLIE GLNLAKE CITY, FL, 320251406Browse FL providers · Browse ZIP 32025
- Phone
- 3864067236
- Primary Specialty
-
Foot & Ankle Surgery
3747P1801X
- Additional Specialty
- Foot & Ankle Surgery
Other Foot & Ankle Surgery Providers in LAKE CITY, FL
| Name | Credential | NPI |
|---|---|---|
| AMANDA STARLING | — | 1487815791 |
| STACEY WILCOX | — | 1063021889 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.