Provider Demographics
NPI:1821557372
Name:SEBATTA, NATHAN (RN)
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:SEBATTA
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 LEXINGTON ST APT 5
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-4750
Mailing Address - Country:US
Mailing Address - Phone:617-642-4638
Mailing Address - Fax:
Practice Address - Street 1:140 LEXINGTON ST APT 5
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-4750
Practice Address - Country:US
Practice Address - Phone:617-642-4638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-14
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2262650163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health