Individual
JEFFREY PAUL BLISE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7226
(920) 445-7289
Mailing address
744 S WEBSTER AVE, GREEN BAY, WI 54301-3505
(920) 445-7226
(920) 445-7289
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
78344-030
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44346200
—
WI
Enumeration date
04/11/2006
Last updated
11/17/2022
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