Healthcare Provider Details

I. General information

NPI: 1487533956
Provider Name (Legal Business Name): ALAAFIA WOMEN CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 N MAYFAIR RD STE 204
MILWAUKEE WI
53222-3219
US

IV. Provider business mailing address

3333 N MAYFAIR RD STE 204
MILWAUKEE WI
53222-3219
US

V. Phone/Fax

Practice location:
  • Phone: 414-432-3555
  • Fax:
Mailing address:
  • Phone: 414-432-3555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ETHLEEN PEACOCK
Title or Position: CEO
Credential:
Phone: 414-432-3555