Provider Demographics
NPI:1932438439
Name:THICKENING, INGE A (CRNP)
Entity type:Individual
Prefix:
First Name:INGE
Middle Name:A
Last Name:THICKENING
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:830 OLD LANCASTER ROAD
Mailing Address - Street 2:BRYN MAWR MEDICAL OFFICE BUILDING NORTH, SUITE 210
Mailing Address - City:BRYN MAWR
Mailing Address - State:PA
Mailing Address - Zip Code:19010
Mailing Address - Country:US
Mailing Address - Phone:610-527-1600
Mailing Address - Fax:610-527-0824
Practice Address - Street 1:830 OLD LANCASTER ROAD
Practice Address - Street 2:BRYN MAWR MEDICAL OFFICE BUILDING NORTH, SUITE 210
Practice Address - City:BRYN MAWR
Practice Address - State:PA
Practice Address - Zip Code:19010
Practice Address - Country:US
Practice Address - Phone:610-527-1600
Practice Address - Fax:610-527-0824
Is Sole Proprietor?:No
Enumeration Date:2009-12-11
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP010533363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1747143OtherMLHC B/S AA #
PA440771OtherMLHC MEDICARE AA #
PA1747143OtherMLHC B/S AA #