Individual
MARY JOY E DERLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3883 74TH AVENUE NE, FORT TOTTEN, ND 58335
(701) 766-1600
Mailing address
1401 3RD ST NE APT E, DEVILS LAKE, ND 58301-3323
(701) 350-2409
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
200103
ND
Other
Enumeration date
08/06/2024
Last updated
08/06/2024
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