MEDICARE: MICAH BRONER

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	251E00000X	Home Health Agency

General Provider Information

NPI Number	:	1265371785
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICAH BRONER

Provider Business Mailing Address
First Line	:	4120 ANSAR LN
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46254-3123
Country	:	US
Telephone Number	:	463-206-7760
Fax Number	:

Provider Business Practice Location Address
First Line	:	1134 N MOUNT ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46222-3151
Country	:	US
Telephone Number	:	463-206-7760
Fax Number	:

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

Provider Enumeration Date	:	03/27/2026
Last Update Date	:	03/27/2026

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Directions to “ MICAH BRONER ” Practice Location

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