Provider Demographics
NPI:1811556715
Name:LADUKE, TORI LYNN (APRN)
Entity Type:Individual
Prefix:MRS
First Name:TORI
Middle Name:LYNN
Last Name:LADUKE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:638 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:AR
Mailing Address - Zip Code:71701-4699
Mailing Address - Country:US
Mailing Address - Phone:870-836-1000
Mailing Address - Fax:
Practice Address - Street 1:638 CALIFORNIA AVE SW
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:AR
Practice Address - Zip Code:71701-4604
Practice Address - Country:US
Practice Address - Phone:870-836-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-13
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR120491282NR1301X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No282NR1301XHospitalsGeneral Acute Care HospitalRural