Healthcare Provider Details

I. General information

NPI: 1902973456
Provider Name (Legal Business Name): TERESA LYNN COHAN CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 N CLAYTON ST 6TH FLOOR
WILMINGTON DE
19805-3165
US

IV. Provider business mailing address

701 N CLAYTON ST 6TH FLOOR
WILMINGTON DE
19805-3165
US

V. Phone/Fax

Practice location:
  • Phone: 302-421-4695
  • Fax: 302-421-4698
Mailing address:
  • Phone: 302-421-4695
  • Fax: 302-421-4698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberLP0000289
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: