# CANYON CREEK HEALTH AND WELLNESS

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

## Provider details

- **NPI number:** 1891675021
- **Authorized official:** JENTRY CORA MCKELL NP (NURSE PRACTIONER)
- **Authorized official phone:** (801) 310-5878

## Contact information

- **Practice address:** 245 E 400 S, SPRINGVILLE, UT 84663-1957
- **Practice address phone:** (385) 543-5266
- **Practice address fax:** (385) 503-2493
- **Mailing address:** 245 E 400 S, SPRINGVILLE, UT 84663-1957
- **Mailing address phone:** (385) 543-5266
- **Mailing address fax:** (385) 503-2493

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 09/08/2025
- **Last updated:** 09/08/2025