Provider Demographics
NPI:1912407875
Name:BLOOD, SARAH M
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:BLOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 PAGE HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW IPSWICH
Mailing Address - State:NH
Mailing Address - Zip Code:03071-3918
Mailing Address - Country:US
Mailing Address - Phone:603-878-4752
Mailing Address - Fax:
Practice Address - Street 1:282 FARMERS ROW
Practice Address - Street 2:
Practice Address - City:GROTON
Practice Address - State:MA
Practice Address - Zip Code:01450-1848
Practice Address - Country:US
Practice Address - Phone:978-448-7666
Practice Address - Fax:978-448-7241
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-17
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH056474-23363LF0000X
MARN265036261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily