Active NPI
Marie Antoinette Tanare Lucco, FNP-BC
- Family Nurse Practitioner
- Banning, CA
National Provider Identifier
1033098801
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 95036257
- Practice address
- 264 N Highland Springs Ave
Banning, CA 92220-3082 - Phone
- (760) 413-3755
- NPI assigned
- Aug 27, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95036257 | CA | Primary |
Addresses
Primary practice location
264 N Highland Springs Ave
Banning, CA 92220-3082
Mailing address
264 N Highland Springs Ave
Banning, CA 92220-3082
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95036257 | CA | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756252800000",
"number": "1033098801",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "264 N HIGHLAND SPRINGS AVE",
"city": "BANNING",
"state": "CA",
"postal_code": "922203082"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "264 N HIGHLAND SPRINGS AVE",
"city": "BANNING",
"state": "CA",
"postal_code": "922203082",
"telephone_number": "760-413-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUCCO",
"first_name": "MARIE ANTOINETTE",
"middle_name": "TANARE",
"name_prefix": "Mrs.",
"credential": "FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-08-27",
"last_updated": "2025-08-27",
"certification_date": "2025-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "95036257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Banning, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.