Provider Demographics
NPI:1285797472
Name:BACKEY, CHRISTINE (BSW, MS)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:
Last Name:BACKEY
Suffix:
Gender:F
Credentials:BSW, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1212 N SHORE DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32208-4344
Mailing Address - Country:US
Mailing Address - Phone:912-882-5989
Mailing Address - Fax:
Practice Address - Street 1:96098 VICTORIAS PLACE
Practice Address - Street 2:
Practice Address - City:YULEE
Practice Address - State:FL
Practice Address - Zip Code:32097
Practice Address - Country:US
Practice Address - Phone:904-321-4097
Practice Address - Fax:904-321-5668
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator