Healthcare Provider Details

I. General information

NPI: 1942197181
Provider Name (Legal Business Name): NANCY ELLEN SNYDER MCKINNEY COTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2025
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7900 CONSTITUTION AVE NE
ALBUQUERQUE NM
87110-7513
US

IV. Provider business mailing address

218 LAUREL CREEK CT
SPRUCE PINE NC
28777-3134
US

V. Phone/Fax

Practice location:
  • Phone: 505-296-5565
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number15061
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License NumberOT-2025-0105
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: