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NPI Code Detail

MEDICARE: MARAL MEHRABAN APRN

MEDICARE: MARAL MEHRABAN APRN
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
1163WE0003XEmergency Registered Nurse1172500KY
2363LF0000XFamily Nurse Practitioner4043455KY

General Provider Information

NPI Number : 1194513556
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARAL MEHRABAN APRN
Provider Business Mailing Address
First Line : 1850 BLUEGRASS AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40215-1161
Country : US
Telephone Number : 502-361-6391
Fax Number :
Provider Business Practice Location Address
First Line : 1850 BLUEGRASS AVE
Second Line :
City : LOUISVILLE
State : KY
Zip : 40215-1161
Country : US
Telephone Number : 502-361-6391
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2025
Last Update Date : 01/19/2026

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Directions to “ MARAL MEHRABAN APRN” Practice Location

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