Provider Demographics
NPI:1497878755
Name:LESCHISIN, DEBRA ANN (RN-C)
Entity Type:Individual
Prefix:MS
First Name:DEBRA
Middle Name:ANN
Last Name:LESCHISIN
Suffix:
Gender:F
Credentials:RN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:242 100TH AVE
Mailing Address - Street 2:
Mailing Address - City:CLAYTON
Mailing Address - State:WI
Mailing Address - Zip Code:54004-3113
Mailing Address - Country:US
Mailing Address - Phone:715-948-2897
Mailing Address - Fax:715-948-2897
Practice Address - Street 1:100 POLK COUNTY PLZ
Practice Address - Street 2:SUITE 180
Practice Address - City:BALSAM LAKE
Practice Address - State:WI
Practice Address - Zip Code:54810-9071
Practice Address - Country:US
Practice Address - Phone:715-485-8500
Practice Address - Fax:715-485-8877
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health