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

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