Mrs. BEVERLEY ANN BLAKE ODOHERTY CFNP
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1821166539- Provider Type
- Individual Provider (NPI-1)
- Credentials
- CFNP
- Status
- Active
Contact & Location
- Address
- 801 POLE LINE RD W, TWIN FALLS, ID, 833015810
- Phone
- (208) 814-4100
- Fax
- (208) 814-4908
Specialties & Taxonomies
Nurse Practitioner
License: CO #RN172038
Nurse Practitioner, Family
Primary License: ID #NP925A