Provider Demographics
NPI:1467943001
Name:LESEM, SARENA NICOLE (CNM)
Entity type:Individual
Prefix:
First Name:SARENA
Middle Name:NICOLE
Last Name:LESEM
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MOUNT AUBURN ST
Mailing Address - Street 2:PARSONS 2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5597
Mailing Address - Country:US
Mailing Address - Phone:781-646-1043
Mailing Address - Fax:781-646-1935
Practice Address - Street 1:22 MILL ST STE 204
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-4738
Practice Address - Country:US
Practice Address - Phone:781-646-1043
Practice Address - Fax:781-646-1935
Is Sole Proprietor?:No
Enumeration Date:2018-05-18
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN10015603367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110218118AMedicaid