MEDICARE: DEBRA BLIESNER RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC1600X	Continuing Education/Staff Development Registered Nurse	472349	CA

General Provider Information

NPI Number	:	1154254951
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEBRA BLIESNER RN

Provider Business Mailing Address
First Line	:	71 BLAKE AVE
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-0541
Country	:	US
Telephone Number	:	540-219-1259
Fax Number	:

Provider Business Practice Location Address
First Line	:	71 BLAKE AVE
Second Line	:
City	:	WATSONVILLE
State	:	CA
Zip	:	95076-0541
Country	:	US
Telephone Number	:	540-219-1259
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2026
Last Update Date	:	06/03/2026

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