Provider Demographics
NPI:1174172316
Name:BARKALOW, AHJAINENE (PA-C)
Entity type:Individual
Prefix:
First Name:AHJAINENE
Middle Name:
Last Name:BARKALOW
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:AHJAINENE
Other - Middle Name:TIAHNA
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2598 W WHITE RIVER BLVD
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47303-5251
Practice Address - Country:US
Practice Address - Phone:765-747-3888
Practice Address - Fax:765-288-6139
Is Sole Proprietor?:No
Enumeration Date:2019-09-10
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA196245363A00000X
IN10004016A363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant