Lookup NPI Numbers from the NPI Registry
NPI Profile for BEVERLEY A BLAKE ODOHERTY in TWIN FALLS, ID.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Family |
363LF0000X | 50 | Nurse Practitioner | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI # | 1821166539 |
|
| Status | Active | |
| Credentials | CFNP | |
| Entity | Individual | |
| Enumeration date | 12/01/2006 | |
| Last updated | 09/09/2024 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
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| Hospital affiliation(s) |
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BEVERLEY A BLAKE ODOHERTY
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BEVERLEY A BLAKE ODOHERTY, CFNP