Healthcare Provider Details

I. General information

NPI: 1871460899
Provider Name (Legal Business Name): MADISON RUANE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2025
Last Update Date: 04/02/2026
Certification Date: 04/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 JEFFERSON AVE
WASHINGTON PA
15301-3822
US

IV. Provider business mailing address

84 W SOUTH ST
WILKES BARRE PA
18766-0003
US

V. Phone/Fax

Practice location:
  • Phone: 724-993-8000
  • Fax:
Mailing address:
  • Phone: 800-945-5378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP034376
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: