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General NPI Number Information
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NPI Number | 1174172316
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Entity Type | Individual
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Provider Name | AHJAINENE BARKALOW PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/10/2019
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 2598 W WHITE RIVER BLVD
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City | MUNCIE
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State | IN
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Zip | 47303-5251
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Country | US
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Telephone | 765-747-3888
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Fax | 765-288-6139
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Provider Business Mailing Address
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Address Line | 250 N SHADELAND AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46219-4959
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA196245
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 10004016A
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License Number State | IN
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