Provider Demographics
NPI:1235936519
Name:AHISSOU, COMLAN PARFAIT
Entity type:Individual
Prefix:
First Name:COMLAN
Middle Name:PARFAIT
Last Name:AHISSOU
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9001 ARBOR ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2066
Mailing Address - Country:US
Mailing Address - Phone:402-718-6900
Mailing Address - Fax:
Practice Address - Street 1:8617 YOUNG ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68122-1012
Practice Address - Country:US
Practice Address - Phone:402-516-6913
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant