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Individual

LETISHA SHARON SEBAKKA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
126 POND ST, WALTHAM, MA 02451-4506
(781) 266-7971
Mailing address
126 POND ST, WALTHAM, MA 02451-4506
(781) 266-7971

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2327811
MA
363LW0102X
Women's Health Nurse Practitioner
Primary
RN2327811
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000
PERSONAL
MA
Enumeration date
11/15/2021
Last updated
04/29/2025
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