Marissa Manipud Marquez, DNP, FNP, RN

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

NP95008125 Issued in CA

Practice address

224 W.D. L Ingram Avenue, BLDG 1408
Cannon Afb, NM 88103

Phone

(575) 784-2778

NPI assigned

Dec 20, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Marissa Abad Manipud Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Corrections and Rehabilitation-Headquarters

  • Pharmacy
  • Blythe, CA
  • NPI 1356976179
  NPD (past)

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745280000000",
    "number": "1992211478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27TH SPECIAL OPERATIONS MEDICAL GROUP",
            "address_2": "224 W.D. L INGRAM AVENUE, BLDG 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "575-784-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 W.D. L INGRAM AVENUE, BLDG 1408",
            "city": "CANNON AFB",
            "state": "NM",
            "postal_code": "88103",
            "telephone_number": "575-784-2778"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19005 Wileys Well Rd",
            "address_purpose": "LOCATION",
            "city": "Blythe",
            "state": "CA",
            "postal_code": "922252287",
            "country_code": "US",
            "telephone_number": "760-921-3000 x7822",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "26501 Avenue 140",
            "address_purpose": "LOCATION",
            "city": "Porterville",
            "state": "CA",
            "postal_code": "932579109",
            "country_code": "US",
            "telephone_number": "559-782-2153",
            "fax_number": "559-782-2073",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARQUEZ",
        "first_name": "MARISSA",
        "middle_name": "MANIPUD",
        "name_prefix": "Dr.",
        "credential": "DNP, FNP, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-20",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95008125",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "CA",
            "license": "NP95008125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARISSA",
            "last_name": "MANIPUD",
            "middle_name": "ABAD",
            "credential": "RN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brandi Konieczynski
• Joseph Lee, PHARMD
• Stephanie Marie Lee
• Abbey Lindholm
• Heather Kimbrell Lopez, RN
• Sara Jean Mathews, MD
• Clifford J McArthur, MS, RDN, CSSD
• Edward McMillan
• Randy C Michael, DO
• Marcia Marie Middel, PH.D.

• Primary Care Nurse Practitioner in Cannon Afb, NM
• Providers in Cannon Afb, NM by specialty
• Primary Care Nurse Practitioner in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.