Fairytale Hair L.L.C

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Legal business name

FAIRYTALE HAIR L.L.C

Doing business as

Fairytale Hair L.L.C

Practice address

1802 S Highway 161
Jacksonville, AR 72076-5511

Phone

(501) 605-3405

NPI assigned

Feb 12, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Breanna Richardson

Title

Owner

Phone

(501) 650-3405

Specialties & licenses 1

Addresses

Other names 1

• Fairytale Hair L.L.C Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1549929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1549929600000",
    "number": "1851857189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "192 WILLIAMSBURG CV",
            "city": "CABOT",
            "state": "AR",
            "postal_code": "720239433",
            "telephone_number": "501-650-3405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1802 S HIGHWAY 161",
            "city": "JACKSONVILLE",
            "state": "AR",
            "postal_code": "720765511",
            "telephone_number": "501-605-3405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAIRYTALE HAIR L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-12",
        "last_updated": "2019-02-12",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "BREANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "501-650-3405"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fairytale Hair L.L.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vicky Evans, M.S., CCC-SLP
• Morgan Evatt
• Eye Physicians & Surgeons
• Eye Physicians & Surgeons
• Melissa W Ezzi, M.S. CCC-SLP
• Families, Inc. of Arkansas
• Melanie Lawren Farmer
• Shane Rex Farmer, PHARMD
• Farrer Physical Therapy Inc
• Valorie Fields, PHARM. D

• Prosthetics Case Management in Jacksonville, AR
• Providers in Jacksonville, AR by specialty
• Prosthetics Case Management in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.