Healthcare Provider Details

I. General information

NPI: 1215827555
Provider Name (Legal Business Name): MEHRAN NICHOLAS VALIYI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2025
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 E MAIN ST APT 1
NEW ALBANY IN
47150-5871
US

IV. Provider business mailing address

818 E MAIN ST APT 1
NEW ALBANY IN
47150-5871
US

V. Phone/Fax

Practice location:
  • Phone: 317-937-2707
  • Fax:
Mailing address:
  • Phone: 317-937-2707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number71018576B
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: