MEDICARE: CHRISTINA KERSHAW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	33011282A	IN
2	1041C0700X	Clinical Social Worker	28560	MD

General Provider Information

NPI Number	:	1851244453
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA KERSHAW

Provider Business Mailing Address
First Line	:	11114 OAK POINTE TRL
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1842
Country	:	US
Telephone Number	:	260-414-5448
Fax Number	:

Provider Business Practice Location Address
First Line	:	11114 OAK POINTE TRL
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46845-1842
Country	:	US
Telephone Number	:	260-414-5448
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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Directions to “ CHRISTINA KERSHAW ” Practice Location

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