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

Mary Joy E Derla

Individual provider Family Nurse Practitioner · NPI 1407686231

Mary Joy E Derla is a Nurse Practitioner in Fort Totten, North Dakota. Qualified in 2024, 2 years ago. Practices with Spirit Lake Tribe, a 21-clinician group and accepts Medicare assignment. Licensed in North Dakota.

Years since qualifying
2
Licensed in
ND
In the registry since
2024

Practice location Address checks out

3883 74th Ave NE
Fort Totten, ND 58335
Phone: (701) 766-1600
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 200103 (ND)

Record details

NPI number1407686231
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 6, 2024
Last updated in NPPESAugust 6, 2024
Certification dateJuly 30, 2024
Mailing address1401 3rd St Ne Apt E, Devils Lake, ND 58301-3323

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Spirit Lake Tribe — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fort Totten