Healthcare Provider Details

I. General information

NPI: 1912407875
Provider Name (Legal Business Name): SARAH M BLOOD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2018
Last Update Date: 02/12/2020
Certification Date: 02/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 FARMERS ROW
GROTON MA
01450-1848
US

IV. Provider business mailing address

192 PAGE HILL RD
NEW IPSWICH NH
03071-3918
US

V. Phone/Fax

Practice location:
  • Phone: 978-448-7666
  • Fax: 978-448-7241
Mailing address:
  • Phone: 603-878-4752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number056474-23
License Number StateNH
# 2
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License NumberRN265036
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: