Provider Demographics
NPI:1235896481
Name:MCNULTY, SARAH ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:ELLEN
Last Name:MCNULTY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1137 ROBIN HILL CT
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-5790
Mailing Address - Country:US
Mailing Address - Phone:667-212-8400
Mailing Address - Fax:
Practice Address - Street 1:1137 ROBIN HILL CT
Practice Address - Street 2:
Practice Address - City:BEL AIR
Practice Address - State:MD
Practice Address - Zip Code:21015-5790
Practice Address - Country:US
Practice Address - Phone:667-212-8400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-23
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR161135163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management