Healthcare Provider Details

I. General information

NPI: 1437159167
Provider Name (Legal Business Name): TERESA SUE BETTS COBAU CNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 10/30/2025
Certification Date: 10/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4216 CORTEZ RD W
BRADENTON FL
34210-3121
US

IV. Provider business mailing address

6627 EMBASSY CT
MAUMEE OH
43537-9648
US

V. Phone/Fax

Practice location:
  • Phone: 941-500-3100
  • Fax:
Mailing address:
  • Phone: 941-500-3100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP03824
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number4704183686
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number003350
License Number StateSD
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP61659047
License Number StateWA
# 5
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number321111
License Number StateAZ
# 6
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number11030201
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: