MEDICARE: LORI RUGG CRNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	SP033546	PA
2	363LF0000X	Family Nurse Practitioner	SP033546	PA

General Provider Information

NPI Number	:	1811867179
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LORI RUGG CRNP

Provider Business Mailing Address
First Line	:	631 OLD SCHOOL HOUSE DR
Second Line	:
City	:	SPRINGFIELD
State	:	PA
Zip	:	19064-1543
Country	:	US
Telephone Number	:	856-430-1065
Fax Number	:

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE STE 53
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3415
Country	:	US
Telephone Number	:	610-658-1928
Fax Number	:	484-476-7816

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/10/2025
Last Update Date	:	02/10/2026

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