Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Lisa Diane Blacketter, CRNA

Individual provider Certified Registered Nurse Anesthetist · NPI 1851630040

Lisa Diane Blacketter, CRNA is a Certified Registered Nurse Anesthetist (CRNA) in Port Lavaca, Texas. Qualified in 2012, 14 years ago. Practices with Citizens Medical Center County of Victoria, a 107-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
14
Licensed in
IL
In the registry since
2013
What do these letters mean?
CRNA — Certified Registered Nurse Anesthetist
An advanced practice nurse who administers anaesthesia.

See every abbreviation used in this directory →

Practice location Address checks out

815 N Virginia St
Port Lavaca, TX 77979-3025
Phone: (361) 552-6713
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2701 Hospital Dr, Victoria, TX 77901-5749 — (361) 573-9181

Specialties & licences

Certified Registered Nurse Anesthetist (primary) Taxonomy 367500000X · Licence 209010216 (IL)

Record details

NPI number1851630040
Entity typeIndividual (Type 1)
GenderFemale
Credentials CRNA
Sole proprietorNo
NPI enumeratedFebruary 7, 2013
Last updated in NPPESJuly 6, 2026
Certification dateJuly 6, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCERTIFIED REGISTERED NURSE ANESTHETIST (CRNA)
Medical schoolOTHER
Graduated 2012 (14 years in practice)
Group practice Citizens Medical Center County Of Victoria — 107 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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