MEDICARE: BRENNAN SCOUT THIENEMAN

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	171400000X	Health & Wellness Coach	Q477526450	IN

General Provider Information

NPI Number	:	1487597910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENNAN SCOUT THIENEMAN

Provider Business Mailing Address
First Line	:	15627 CLUB ESTATES LN
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-8117
Country	:	US
Telephone Number	:	317-512-9047
Fax Number	:

Provider Business Practice Location Address
First Line	:	15627 CLUB ESTATES LN
Second Line	:
City	:	CARMEL
State	:	IN
Zip	:	46033-8117
Country	:	US
Telephone Number	:	317-512-9047
Fax Number	:

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

Provider Enumeration Date	:	04/10/2026
Last Update Date	:	04/10/2026

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Directions to “ BRENNAN SCOUT THIENEMAN ” Practice Location

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