Doctor Name: | MS. DEBRA ANN LESCHISIN |
NPI Number: | 1497878755 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RN-C |
License Number: | |
Business Practice Address: | 100 Polk County Plz Suite 180 Balsam Lake, WI - 548109071 |
Business Phone Number: | 7154858500 |
Business Fax Number: | 7154858877 |
Mailing Address: | 242 100th Ave, CLAYTON |
State: | WI |
Postal Code: | 540043113 |
Phone Number: | 7159482897 |
Fax Number: | 7159482897 |
NPI Enumeration Date: | 04/09/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LW0102X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Women's Health |
Taxonomy Definition: |