Healthcare Provider Details

I. General information

NPI: 1306876727
Provider Name (Legal Business Name): NELLA SANCHEZ-COOK PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 08/27/2021
Certification Date: 08/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1692B HOSPITAL DR STE 202
SANTA FE NM
87505-4825
US

IV. Provider business mailing address

1692B HOSPITAL DR STE 202
SANTA FE NM
87505-4825
US

V. Phone/Fax

Practice location:
  • Phone: 505-982-0639
  • Fax:
Mailing address:
  • Phone: 505-982-6399
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number2977
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT2977
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: