Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Photorealistic Areola & Healing Arts Institute

Organization Other Specialist/Technologist · NPI 1306683255

Photorealistic Areola & Healing Arts Institute is an Other Specialist/Technologist in Springfield, Missouri. Works from 2 locations. Registered with an NPI since 2024.

In the registry since
2024

Practice location Address checks out

4058 S Lone Pine Ave
Springfield, MO 65804-6605
Phone: (417) 763-5414
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 501 S Rancho Dr Ste H51, Las Vegas, NV 89106-4836 — (407) 982-4876

Specialties & licences

Other Specialist/Technologist (primary) Taxonomy 246Z00000X

Record details

NPI number1306683255
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Williams — Billing Manager · (407) 982-4876
NPI enumeratedJuly 9, 2024
Last updated in NPPESOctober 29, 2025
Certification dateOctober 29, 2025
Mailing address4058 S Lone Pine Ave, Springfield, MO 65804-6605

Other providers in Springfield