| Canyonlands Community Health Care | |
|
827 Vista Avenue Page AZ 86040-1625 | |
| (928) 645-9675 | |
| (928) 645-3862 |
| Full Name | Canyonlands Community Health Care |
|---|---|
| Speciality | Family Medicine |
| Location | 827 Vista Avenue, Page, Arizona |
| Authorized Official Name and Position | Christopher J Hansen (CEO) |
| Authorized Official Contact | 9286459675 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Canyonlands Community Health Care Po Box 1625 Page AZ 86040-1625 Ph: (928) 645-9675 | Canyonlands Community Health Care 827 Vista Avenue Page AZ 86040-1625 Ph: (928) 645-9675 |
| NPI Number | 1609966860 |
|---|---|
| Provider Enumeration Date | 10/16/2006 |
| Last Update Date | 09/23/2021 |
| Medicare PECOS PAC ID | 4082509591 |
|---|---|
| Medicare Enrollment ID | O20040219000713 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609966860 | NPI | - | NPPES |
| 432857 | Medicaid | AZ |
| Provider Name | Raymond L Holsten |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003810540 PECOS PAC ID: 8224926662 Enrollment ID: I20040308001097 |
| Provider Name | Jean R Turney-shaw |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871545905 PECOS PAC ID: 1759376338 Enrollment ID: I20040415000206 |
| Provider Name | Dennis J Foley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194729632 PECOS PAC ID: 8022005859 Enrollment ID: I20040426001096 |
| Provider Name | Janeen C Bjork |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932103462 PECOS PAC ID: 1658477492 Enrollment ID: I20070510000487 |
| Provider Name | Laura K Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1477742930 PECOS PAC ID: 5395832307 Enrollment ID: I20071107000260 |
| Provider Name | Lori L Adams |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841669991 PECOS PAC ID: 3577873702 Enrollment ID: I20151030000533 |
| Provider Name | Roberta E Boon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942684253 PECOS PAC ID: 9032410741 Enrollment ID: I20151223000240 |
| Provider Name | Sara K Bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184162729 PECOS PAC ID: 5395020911 Enrollment ID: I20170322002371 |
| Provider Name | Lacey Bennett Celani |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972951119 PECOS PAC ID: 0244522126 Enrollment ID: I20170428001357 |
| Provider Name | Maranda Star Carlile |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376078196 PECOS PAC ID: 2365719051 Enrollment ID: I20170531001474 |
| Provider Name | Michael C Baker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831683465 PECOS PAC ID: 5991057309 Enrollment ID: I20181012002745 |
| Provider Name | Seth C Nolan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831796192 PECOS PAC ID: 4385054931 Enrollment ID: I20201110001416 |
| Provider Name | Brittany J Fat-denatsosie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508463027 PECOS PAC ID: 6800208794 Enrollment ID: I20201217002253 |
| Provider Name | Jeffrey Kiser |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396352589 PECOS PAC ID: 4880008457 Enrollment ID: I20210122002154 |
| Provider Name | Frank S Davis |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1437156205 PECOS PAC ID: 7810302197 Enrollment ID: I20210218001872 |
| Provider Name | Lisa Allison |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699355800 PECOS PAC ID: 2365843190 Enrollment ID: I20210630001089 |
| Provider Name | Rita M Seck |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1457343576 PECOS PAC ID: 4284798067 Enrollment ID: I20210830002716 |
| Provider Name | Michelle Craft |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043975444 PECOS PAC ID: 4183017692 Enrollment ID: I20220204001975 |
| Provider Name | Chad Call |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902478688 PECOS PAC ID: 1951797307 Enrollment ID: I20220412000336 |
| Provider Name | Micah French |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194472415 PECOS PAC ID: 5698153096 Enrollment ID: I20220525001549 |
| Provider Name | Lisa M Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568039386 PECOS PAC ID: 2567865967 Enrollment ID: I20220726000783 |
| Provider Name | Coalette Bedke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295487999 PECOS PAC ID: 8527445915 Enrollment ID: I20220914001387 |
| Provider Name | Inge C Bertram |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013103787 PECOS PAC ID: 8224118716 Enrollment ID: I20220919000630 |
| Provider Name | Brenda Christine Pecotte De Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1083134241 PECOS PAC ID: 2769710011 Enrollment ID: I20220930000592 |
| Provider Name | Shanah Nelson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013641992 PECOS PAC ID: 7719363571 Enrollment ID: I20220930001576 |
| Provider Name | Tracy A Liepke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346537214 PECOS PAC ID: 8224203534 Enrollment ID: I20230501001029 |
| Provider Name | Philip Hartwell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437171253 PECOS PAC ID: 6002989605 Enrollment ID: I20230508002238 |
| Provider Name | David Lewandowski |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1861961690 PECOS PAC ID: 3375993215 Enrollment ID: I20231219001430 |
| Provider Name | Brian L Savery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1104571553 PECOS PAC ID: 2668824152 Enrollment ID: I20240119003666 |
| Provider Name | Candice Lynn Ben |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265769475 PECOS PAC ID: 5597170548 Enrollment ID: I20240509000862 |
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