Individual
JEAN H RUCCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
746 JEFFERSON AVE, SCRANTON, PA 18510-1624
(570) 348-7100
Mailing address
11781 LEE JACKSON MEMORIAL HWY, SUITE 550, FAIRFAX, VA 22033-3309
(571) 777-5102
(703) 563-6256
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
51197
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430052259
RR MEDICARE
PA
Enumeration date
11/21/2005
Last updated
05/23/2016
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