MEDICARE: MADISON RUANE

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	363LF0000X	Family Nurse Practitioner	SP034376	PA

General Provider Information

NPI Number	:	1871460899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MADISON RUANE

Provider Business Mailing Address
First Line	:	84 W SOUTH ST
Second Line	:
City	:	WILKES BARRE
State	:	PA
Zip	:	18766-0003
Country	:	US
Telephone Number	:	800-945-5378
Fax Number	:

Provider Business Practice Location Address
First Line	:	817 JEFFERSON AVE
Second Line	:
City	:	WASHINGTON
State	:	PA
Zip	:	15301-3822
Country	:	US
Telephone Number	:	724-993-8000
Fax Number	:

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

Provider Enumeration Date	:	10/22/2025
Last Update Date	:	04/02/2026

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Directions to “ MADISON RUANE ” Practice Location

Language	Start Address	Practice Location

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