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General NPI Number Information
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NPI Number | 1851244453
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Entity Type | Individual
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Provider Name | CHRISTINA KERSHAW
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Gender | Female
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Dates
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Enumeration Date | 02/16/2026
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Last Update Date | 02/16/2026
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Provider Practice Location Address
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Address Line | 11114 OAK POINTE TRL
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City | FORT WAYNE
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State | IN
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Zip | 46845-1842
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Country | US
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Telephone | 260-414-5448
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Fax |
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Provider Business Mailing Address
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Address Line | 11114 OAK POINTE TRL
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City | FORT WAYNE
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State | IN
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Zip | 46845-1842
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Country | US
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Telephone | 260-414-5448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 33011282A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 28560
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License Number State | MD
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