Healthcare Provider Details

I. General information

NPI: 1336051077
Provider Name (Legal Business Name): SARAH ELIZABETH MULDOON BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 N UNIVERSITY ST
WEST LAFAYETTE IN
47907-2069
US

IV. Provider business mailing address

301 AMERICAN WAY N APT 426
CARMEL IN
46032-7837
US

V. Phone/Fax

Practice location:
  • Phone: 765-494-4004
  • Fax:
Mailing address:
  • Phone: 317-771-9675
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number28297535A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: