Healthcare Provider Details

I. General information

NPI: 1548401706
Provider Name (Legal Business Name): DEBORAH DELIGHT TROY ANP-BC; PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2009
Last Update Date: 09/04/2025
Certification Date: 09/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10971 COUNTY ROAD 53 E
MIZPAH MN
56660-9553
US

IV. Provider business mailing address

10971 COUNTY ROAD 53 E
MIZPAH MN
56660-9553
US

V. Phone/Fax

Practice location:
  • Phone: 218-766-5590
  • Fax: 254-488-3272
Mailing address:
  • Phone: 218-766-5590
  • Fax: 254-488-3272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR-153536-7
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2012005172
License Number StateMD
# 3
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2008011658
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: