Healthcare Provider Details

I. General information

NPI: 1124953302
Provider Name (Legal Business Name): TORI L KEMP FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1445 HAMILTON AVE E
WYNNE AR
72396-2514
US

IV. Provider business mailing address

1445 HAMILTON AVE E
WYNNE AR
72396-2514
US

V. Phone/Fax

Practice location:
  • Phone: 870-208-4629
  • Fax:
Mailing address:
  • Phone: 870-208-4629
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number237986
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: