Healthcare Provider Details

I. General information

NPI: 1609426956
Provider Name (Legal Business Name): AJA N AVILES MSN, CNM, APNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/18/2019
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2906 S 20TH ST
MILWAUKEE WI
53215-3732
US

IV. Provider business mailing address

1032 S CESAR E CHAVEZ DR
MILWAUKEE WI
53204-2203
US

V. Phone/Fax

Practice location:
  • Phone: 414-897-5511
  • Fax: 414-385-7552
Mailing address:
  • Phone: 414-672-1353
  • Fax: 262-408-5094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number9585-33
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number148983
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: