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NPI Code Detail

MEDICARE: AJA HEALING

MEDICARE: AJA HEALING
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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1427840503
Entity Type Code : Organization
Provider Name (Legal Business Name) : AJA HEALING
Provider Business Mailing Address
First Line : 8430 W CAPITOL DR STE 3025
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1846
Country : US
Telephone Number : 262-457-9815
Fax Number :
Provider Business Practice Location Address
First Line : 8430 W CAPITOL DR STE 3025
Second Line :
City : MILWAUKEE
State : WI
Zip : 53222-1846
Country : US
Telephone Number : 262-457-9815
Fax Number :
Authorized Official
Title or Position : DR. HOLISTIC MEDICINE
Name : DR. SHANICE BAQUET
Credential : DHM
Telephone Number : 262-457-9815
Provider Enumeration Date : 05/22/2025
Last Update Date : 05/22/2025

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Directions to “AJA HEALING ” Practice Location

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