Provider Demographics
NPI:1518037670
Name:THAL, WENDY SUSAN HILL (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:WENDY
Middle Name:SUSAN HILL
Last Name:THAL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:WENDY
Other - Middle Name:SUSAN
Other - Last Name:MARKUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:255 W. LANCASTER AVE.
Mailing Address - Street 2:SUITE 202
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301
Mailing Address - Country:US
Mailing Address - Phone:610-647-5544
Mailing Address - Fax:610-647-5545
Practice Address - Street 1:1615 E. BOOT RD.
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380
Practice Address - Country:US
Practice Address - Phone:610-692-7766
Practice Address - Fax:610-918-9065
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2014-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAVP001592C363LA2200X
PAVP001592-C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health