Nurse Practitioner Furnishing Number Application
This document provides instructions for applying for a Nurse Practitioner Furnishing Number in California. It outlines the necessary forms and documents to include for both California-based and non-California based Nurse Practitioner education program graduates. Ensure all requirements are met to avoid delays in your application process.
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How do I fill this out?
Filling out the Nurse Practitioner Furnishing Number application requires careful attention to detail. Start by gathering all necessary documents as outlined in the instructions. Then, complete the online application form accurately to ensure a smooth processing experience.
How to fill out the Nurse Practitioner Furnishing Number Application?
1
Gather the necessary documents required for the application.
2
Complete the Online Nurse Practitioner Furnishing Number Application.
3
Submit the Advanced Pharmacology Course Verification form.
4
Provide proof of employment history if applicable.
5
Ensure all documents are submitted to the designated address.
Who needs the Nurse Practitioner Furnishing Number Application?
1
Nurse Practitioners applying for a furnishing number in California.
2
Healthcare providers wanting to prescribe medication.
3
Recent graduates from Nurse Practitioner programs seeking licensure.
4
U.S. Armed Forces members looking for expedited review.
5
Employers hiring Nurse Practitioners needing verification of qualifications.
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What are the instructions for submitting this form?
To submit the Nurse Practitioner Furnishing Number application, you may apply online or send the completed form to the California Board of Registered Nursing at PO Box 944210, Sacramento, CA 94244-2100. Ensure all documentation is included to avoid delays. If required, you can also send documents via fax at (916) 574-8637.
What are the important dates for this form in 2024 and 2025?
Important dates for submitting this form are ongoing, but keep in mind application processing times may vary. It's recommended to apply in advance of any planned practice or employment changes. Stay updated on any deadlines that may apply to specific programs or requirements.
What is the purpose of this form?
The purpose of this form is to allow Nurse Practitioners in California to apply for a furnishing number. This number enables practitioners to prescribe medications, thereby expanding their practice capabilities and improving patient care. Proper completion and submission of this application are vital for compliance with state regulations.
Tell me about this form and its components and fields line-by-line.
- 1. Last Name: Printed or typed last name of the applicant.
- 2. First Name: Printed or typed first name of the applicant.
- 3. Middle Name: Printed or typed middle name of the applicant.
- 4. Address: Complete street address of the applicant.
- 5. Date of Birth: Applicant's birth date in MM/DD/YYYY format.
- 6. Telephone Number: Home and alternate phone numbers for the applicant.
- 7. California RN License Number: The applicant's registered nursing license number.
- 8. U.S. Social Security Number: Applicant’s social security number or taxpayer ID.
- 9. Previous Names: List of any previous names including maiden names.
- 10. Mother's Maiden Name: Last name of the applicant's mother.
- 11. CA NP Number: California Nurse Practitioner license number.
- 12. Dates Course Was Taken: The period during which the Advanced Pharmacology Course was completed.
- 13. Signature of Applicant: The applicant's signature affirming the application.
- 14. Date: The date when the applicant signed the application.
What happens if I fail to submit this form?
Failure to submit this form can result in the inability to legally prescribe medications as a Nurse Practitioner. Your application will not be processed until all required documents are submitted correctly. It's critical to ensure submission is complete to avoid setbacks in your practice.
- Inability to Prescribe: Without the furnishing number, you cannot prescribe medications.
- Delays in Processing: Incomplete applications lead to longer processing times.
- Potential Disciplinary Action: Falsified applications may result in disciplinary measures from the board.
- Ineligibility for Expedited Review: Incomplete submissions may disqualify you from expedited processing.
- Need for Re-submission: You may need to start the application process over if documents are missing.
How do I know when to use this form?
- 1. Initial Application: Use this form as your first step to obtain a furnishing number.
- 2. Updates on Qualifications: When there are changes to your qualifications or licensure, submit this form.
- 3. Transitioning Licenses: If moving from another state, use this form to gain California licensing credentials.
- 4. Reapplying after Denial: If your previous application was denied, use this for a new submission.
- 5. Periodic Renewals: When required, submit this form to renew your furnishing number.
Frequently Asked Questions
What is the Nurse Practitioner Furnishing Number application?
It is a form required for California-based Nurse Practitioners to prescribe medication.
How can I edit the PDF file?
Upload the file to PrintFriendly and use the editing tools provided to make changes.
Do I need to pay a fee for the application?
Yes, applicable fees must accompany the completed application.
What documents are required with the application?
You need the Advanced Pharmacology Course Verification form and proof of employment.
Can military personnel receive expedited review?
Yes, honorably discharged military members can receive expedited processing.
Is the application available online?
Yes, the application can be completed and submitted online.
How do I know if my application is approved?
You will receive a notification from the Board of Registered Nursing regarding your application status.
What if I submit false information?
Falsification may result in denial of your application and disciplinary action.
How can I share my filled PDF?
After editing, use the share options to send the PDF via email or social media.
Is it necessary to print the application?
You can submit it online, but printing a copy for your records is recommended.
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