Provider Demographics
NPI:1962221143
Name:DEYOUNG, TROY DONALD (REGISTERED NURSE BSN)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:DONALD
Last Name:DEYOUNG
Suffix:
Gender:M
Credentials:REGISTERED NURSE BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:MARSHFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:54449-1254
Mailing Address - Country:US
Mailing Address - Phone:920-763-5245
Mailing Address - Fax:
Practice Address - Street 1:1608 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:MARSHFIELD
Practice Address - State:WI
Practice Address - Zip Code:54449-1254
Practice Address - Country:US
Practice Address - Phone:920-763-5245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-07
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program