Individual
MARK DUWAYNE DEIS
Active
Individual
MARK DUWAYNE DEIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
56634973102
UT
363LF0000X
Family Nurse Practitioner
Primary
5663497-4405
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1275134132
COMMERCIAL INSURANCE
UT
05
—
1275134132
—
UT
Enumeration date
10/27/2021
Last updated
10/18/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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