# CANYONLANDS COMMUNITY HEALTH CARE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609966860
- **Authorized official:** CHRISTOPHER J HANSEN (CEO)
- **Authorized official phone:** (928) 645-9675

## Contact information

- **Practice address:** 827 VISTA AVENUE, PAGE, AZ 86040-1625
- **Practice address phone:** (928) 645-9675
- **Practice address fax:** (928) 645-3862
- **Mailing address:** PO BOX 1625, PAGE, AZ 86040-1625
- **Mailing address phone:** (928) 645-9675
- **Mailing address fax:** (928) 645-3030

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | — | AZ | — |
| 207Q00000X | Family Medicine Physician | — | AZ | Yes |
| 207R00000X | Internal Medicine Physician | — | AZ | — |
| 207V00000X | Obstetrics & Gynecology Physician | — | AZ | — |
| 363AM0700X | Medical Physician Assistant | — | AZ | — |
| 363AS0400X | Surgical Physician Assistant | — | AZ | — |
| 363L00000X | Nurse Practitioner | — | AZ | — |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 09/23/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 432857 | — | AZ |