Healthcare Provider Details

I. General information

NPI: 1477476059
Provider Name (Legal Business Name): DIANNE KATLEEN MOTIL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3401 CIVIC CENTER BLVD
PHILADELPHIA PA
19104-4319
US

IV. Provider business mailing address

1755 N HILLS DR
NORRISTOWN PA
19401-5701
US

V. Phone/Fax

Practice location:
  • Phone: 609-634-6489
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0200X
TaxonomyPediatric Clinical Nurse Specialist
License NumberCNS000390
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: