Provider Demographics
NPI:1982462735
Name:KOMBO, HILDER
Entity type:Individual
Prefix:
First Name:HILDER
Middle Name:
Last Name:KOMBO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 JACK NICKLAUS CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-5051
Mailing Address - Country:US
Mailing Address - Phone:501-352-6253
Mailing Address - Fax:
Practice Address - Street 1:8 JACK NICKLAUS CV
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72210-5051
Practice Address - Country:US
Practice Address - Phone:501-352-6253
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR494253747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant