Provider Demographics
NPI:1033589445
Name:BACKSMAN, CHRISTOPHER ROBERT (APRN)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ROBERT
Last Name:BACKSMAN
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:CHRISTOPHER
Other - Last Name:ERIGO-BACKSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:255 LANCASTER DR NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97301-5155
Mailing Address - Country:US
Mailing Address - Phone:503-576-8400
Mailing Address - Fax:503-364-0775
Practice Address - Street 1:255 LANCASTER DR NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-5155
Practice Address - Country:US
Practice Address - Phone:503-576-8400
Practice Address - Fax:503-364-0775
Is Sole Proprietor?:No
Enumeration Date:2015-09-28
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9258522363L00000X, 363LF0000X
FLARNP9258522363LA2200X
OR10016527363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily