Provider Demographics
NPI:1154916773
Name:MCKEOWN, CHRIS (FNP-C)
Entity type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:MCKEOWN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:675 ORCHARD HEIGHTS RD NW STE 120
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97304-3042
Mailing Address - Country:US
Mailing Address - Phone:815-499-4742
Mailing Address - Fax:
Practice Address - Street 1:675 ORCHARD HEIGHTS RD NW STE 120
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97304-3042
Practice Address - Country:US
Practice Address - Phone:815-499-4742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2022-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209022602363L00000X
OR202107301NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner