Provider Demographics
NPI:1659153880
Name:RUBY, MADALYN PAIGE
Entity Type:Individual
Prefix:
First Name:MADALYN
Middle Name:PAIGE
Last Name:RUBY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1174 NAVAHO DR UNIT B
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-9660
Mailing Address - Country:US
Mailing Address - Phone:513-292-9152
Mailing Address - Fax:
Practice Address - Street 1:1174 NAVAHO DR UNIT B
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-9660
Practice Address - Country:US
Practice Address - Phone:513-292-9152
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide