Raven Kiara Lee, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

329980 Issued in MS

Practice address

340 Stateline Rd W
Southaven, MS 38671-1610

Phone

(662) 579-3955

NPI assigned

Apr 7, 2021

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Raven Kiara Coleman Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617753600000",
    "number": "1124607908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6681 BOYLSTON DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381410770",
            "telephone_number": "901-759-8482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 STATELINE RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386711610",
            "telephone_number": "662-579-3955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "RAVEN",
        "middle_name": "KIARA",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-07",
        "last_updated": "2021-04-07",
        "certification_date": "2021-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MS",
            "license": "329980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAVEN",
            "last_name": "COLEMAN",
            "middle_name": "KIARA",
            "credential": "LPN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Learning to Live Again
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• Lee Grimm, M.D., P.C.
• Daniel Lee, MD
• Markarius Lee
• Stephanie Denise Lee, PHARMD
• Lending Care Transportation
• Lending Care Transportation
• Melissa D. Leonard, PT
• Paul Sheldon Leonard, PH.D.

• All providers in Southaven, MS
• Licensed Practical Nurse in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.