Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Beverley Ann Blake Odoherty, CFNP

Individual provider Nurse Practitioner · NPI 1821166539

Mrs. Beverley Ann Blake Odoherty, CFNP is a Nurse Practitioner in Twin Falls, Idaho. Qualified in 1996, 30 years ago. Practices with South Sound Inpatient Physicians PLLC, a 427-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Colorado and Idaho.

Years since qualifying
30
Licensed in
CO, ID
In the registry since
2006
Specialties on file
2
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Practice location Address checks out

801 Pole Line Rd W
Twin Falls, ID 83301-5810
Phone: (208) 814-4100
Fax: (208) 814-4908
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 777 Hospital Way, Pocatello, ID 83201-5175 — (208) 239-1000

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence NP925A (ID)
Nurse Practitioner Taxonomy 363L00000X · Licence RN172038 (CO)

Record details

NPI number1821166539
Entity typeIndividual (Type 1)
GenderFemale
Credentials CFNP
Sole proprietorYes
NPI enumeratedDecember 1, 2006
Last updated in NPPESSeptember 9, 2024
Certification dateSeptember 9, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice South Sound Inpatient Physicians Pllc — 427 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Twin Falls