MARISSA BLANCO (LPC, FNP) – Family Nurse Practitioner, NPI 1386644821

MARISSA BLANCO (LPC, FNP) is a healthcare provider. based in Lubbock, Texas. specializing in NURSE PRACTITIONER. They hold the professional credentials LPC, FNP. They hold a License No. 10875 (TX). The NPI Number for MARISSA BLANCO (LPC, FNP) is 1386644821

Main info

Female
15 Years Of Experience
Accepts Medicare Assignment
Name
MARISSA BLANCO (LPC, FNP)
NPI
1386644821
Phone
(806) 765-2611
Address
1313 BROADWAY STE 5
Enumeration Date
27 July 2005
Last Update Date
13 August 2024

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
8067652611
Graduation Year
2011 (15 years ago)
PAC ID
6608031539
Group Practice PAC ID
6002710860
Professional Enrollment ID
I20240913000034
Address ID
TX794012622LU1610XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness75
Years active:20State licenses:2Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

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Provider Addresses for MARISSA BLANCO (LPC, FNP)

  • 1313 BROADWAY STE 5

    LUBBOCK, TX 794013209

    Phone: (806) 765-2611

    Fax: (806) 741-3012

    Type: Mailing

  • 1610 5TH ST

    LUBBOCK, TX 794012622

    Phone: (806) 765-2611

    Fax: (806) 741-3012

    Type: Mailing

  • Community Health Care Center of Lubbock, 1318, Broadway Street, Lubbock, Texas, 79401, United States

    LUBBOCK, TX 794013206

    Phone: (806) 765-2611

    Fax: (806) 741-3012

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-09-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240913000034INurse PractitionerTXTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 79401)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6002710860View full group profile
NameSpecialtyState
Family PracticeTX
Nurse PractitionerTX
Certified Nurse Midwife (Cnm)TX
Mental Health CounselorTX
Family PracticeTX
Nurse PractitionerTX
Osteopathic Manipulative Medicine, Family PracticeTX
O P T O M E T R YTX
Nurse PractitionerTX
Mental Health CounselorTX

Reviews

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Frequently asked questions

What is the 10-digit NPI for MARISSA BLANCO (LPC, FNP)?
MARISSA BLANCO (LPC, FNP) — NPI 1386644821 — is the standard way to identify this listing.
Does the file indicate MARISSA BLANCO (LPC, FNP) is practicing under active NPI?
Directory data currently reports MARISSA BLANCO (LPC, FNP) as active.
What taxonomy line describes MARISSA BLANCO (LPC, FNP)?
For research purposes, treat MARISSA BLANCO (LPC, FNP) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
Where is MARISSA BLANCO (LPC, FNP) based?
MARISSA BLANCO (LPC, FNP) is tied to Lubbock, Texas in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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