Healthcare Provider Details

I. General information

NPI: 1043092927
Provider Name (Legal Business Name): KAMEO HEALTH WELLNESS AND BEAUTY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2023
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3490 W 3300 S APT 7
WEST HAVEN UT
84401-9232
US

IV. Provider business mailing address

3490 W 3300 S APT 7
WEST HAVEN UT
84401-9232
US

V. Phone/Fax

Practice location:
  • Phone: 801-301-0182
  • Fax: 801-877-0795
Mailing address:
  • Phone: 801-301-0182
  • Fax: 801-877-0795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARK DUWAYNE DEIS
Title or Position: OWNER
Credential: NP
Phone: 801-726-3738