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1689675563

NPI Code Detail

MEDICARE: PETRA M LAEVEN-SESSIONS MD

MEDICARE: PETRA M LAEVEN-SESSIONS MD

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
1	208000000X	Pediatrics Physician	9639	MT
2	208000000X	Pediatrics Physician	62317-20	WI
3	208000000X	Pediatrics Physician	MD60147163	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689675563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETRA M LAEVEN-SESSIONS MD

Provider Business Mailing Address
First Line	:	130 2ND ST
Second Line	:	PEDIATRIC HOSPITALIST DEPT
City	:	NEENAH
State	:	WI
Zip	:	54956-2883
Country	:	US
Telephone Number	:	920-969-7900
Fax Number	:	920-969-7979

Provider Business Practice Location Address
First Line	:	130 2ND ST
Second Line	:	PEDIATRIC HOSPITALIST DEPT
City	:	NEENAH
State	:	WI
Zip	:	54956-2883
Country	:	US
Telephone Number	:	920-969-7900
Fax Number	:	920-969-7979

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/27/2014

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Directions to “ PETRA M LAEVEN-SESSIONS MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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