Organization
CANYONLANDS COMMUNITY HEALTH CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J HANSEN (CEO)
(928) 645-9675
Entity
Organization
Contact information
Practice address
827 VISTA AVENUE, PAGE, AZ 86040-1625
(928) 645-9675
(928) 645-3862
Mailing address
PO BOX 1625, PAGE, AZ 86040-1625
(928) 645-9675
(928) 645-3030
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
AZ
207Q00000X
Family Medicine Physician
Primary
—
AZ
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
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432857
—
AZ
Enumeration date
10/16/2006
Last updated
09/23/2021
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