Provider Demographics
NPI:1972200632
Name:MCKAY, SANDI BLOOD (NP)
Entity type:Individual
Prefix:
First Name:SANDI
Middle Name:BLOOD
Last Name:MCKAY
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 LIPPINCOTT DR STE 410
Mailing Address - Street 2:
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-4197
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:
Practice Address - Street 1:517 ROUTE 72 W
Practice Address - Street 2:
Practice Address - City:MANAHAWKIN
Practice Address - State:NJ
Practice Address - Zip Code:08050-2821
Practice Address - Country:US
Practice Address - Phone:609-677-7211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR19928500163WI0500X
PARN729932163WI0500X
NJ26NJ14958000363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WI0500XNursing Service ProvidersRegistered NurseInfusion Therapy
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily