Healthcare Provider Details

I. General information

NPI: 1710823521
Provider Name (Legal Business Name): MICAH ARZIE JAMES PRAUNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2026
Last Update Date: 04/24/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

611 VALLEY DR STE A
WAYNE NE
68787-2277
US

IV. Provider business mailing address

300 S 5TH ST
BATTLE CREEK NE
68715-4463
US

V. Phone/Fax

Practice location:
  • Phone: 402-649-3059
  • Fax: 402-649-3059
Mailing address:
  • Phone: 402-649-3059
  • Fax: 402-649-3059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberH14143555
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: