Healthcare Provider Details

I. General information

NPI: 1649135831
Provider Name (Legal Business Name): BRANDY MOTTER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 BERNVILLE RD
READING PA
19605-9453
US

IV. Provider business mailing address

1038 KUTZTOWN RD
MYERSTOWN PA
17067-1615
US

V. Phone/Fax

Practice location:
  • Phone: 610-378-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WF0300X
TaxonomyFlight Registered Nurse
License NumberRN618520
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: