Provider Demographics
NPI:1437159167
Name:BETTS COBAU, TERESA SUE (CNP, CNM)
Entity type:Individual
Prefix:
First Name:TERESA
Middle Name:SUE
Last Name:BETTS COBAU
Suffix:
Gender:F
Credentials:CNP, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6627 EMBASSY CT
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-9648
Mailing Address - Country:US
Mailing Address - Phone:941-500-3100
Mailing Address - Fax:
Practice Address - Street 1:4216 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3121
Practice Address - Country:US
Practice Address - Phone:941-500-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-07-22
Last Update Date:2025-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP03824363LW0102X
MI4704183686363LW0102X
SD003350363LW0102X
WAAP61659047363LW0102X
AZ321111363LW0102X
FL11030201363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00400589OtherRAILROAD MEDICARE
OH0460620Medicaid
P00400589OtherRAILROAD MEDICARE
OH0460620Medicaid
S34261Medicare UPIN