how to change last name on nursing license

Top-requested sites to log in to services provided by the state. You may submit changes in address of record to the Board by one of the following methods: You may submit name changes to the Board using the following method: You must upload a copy of the required legal documentation certifying the name change. Last Name. Thereafter, we will send renewal information to the name and address we have on file for you (see Address or Name Changes, below) at least four months before your registration expires. Please do not send a paper request to the Board office. 3. The Board will accept the following legal documents as proof of a name change: Marriage Certificate. There are . Share sensitive information only on official, secure websites. Per Wis. Stat. Keystone State. Probate Court Document. If you are changing your name, you must submit a copy of the legal document that changes your name(i.e. First Name. T.C.A. You can send the documentation to: - Fax: 317-233-4236 Attn: Nursing Group - Email: pla2@pla.in.gov To request that the Board electronically send a Verification of License with History to another state licensing agency, login with your User ID and Password and locate the Professional License Details section on your dashboard. You will need your Online Licensing username and password If you do not have an account yet, you may search for your records with your date of birth and SSN You cannot request a name change through the online portal. This page is located more than 3 levels deep within a topic. Do not include sensitive information, such as Social Security or bank account numbers. Name Change/Address Change/Duplicate licenseYou can request a name or address change online at www.pals.pa.gov. Follow To have your name changed you must submit an official name change document such as a marriage certificate or divorce decree. To notify the Board of a newly acquired Social Security number or to correct a Social Security number or date of birth, please complete the Affidavit to Verify Social Security Number and Date of Birth formand submit to the Board. Change Your Address or Employer. for Verification of social security number and/or date of birth. If you are requesting a name change and you have a current or expired license with another board within the Bureau of Health Professions Licensure, the requested name change will be effective for all boards. Enter your previous . E-Prescribing Waiver Information and Application . Login with your You or your employer can verify and print licensure status by accessing the Board Check a License site. I recently married / divorced how do I change my name? Completion will change your name or address in the North Carolina Board of Nursing records. 17 S. High Street, Suite 660 Columbus, OH 43215 . Name Change Instructions Log-into Nurse Portal https://azbn.boardsofnursing.org/azbn Click on link "Manage Profile" (on the left under your address) Click on "Demographics" Click on "Request Name Change" Type in Current Name Click on "Upload" Click on "+ Add File" Find & attach the official documents that show your previous name Youmustprovide a current, working email address to receive license renewal information and important messages from the Board. 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Fax: For registered nurses and licensed practical nurses: (410) 358-3530 . Board Rule 217.7 requires name and address changes to be submitted to the Board in writing. Attention: Name and Address Change Department . Licences must be renewed every two years. Email. PROCESSING TIME: If you are submitting an name change request by mail, please allow 5-7 business days for processing. Search Search. General Inquiries MO Board of Nursing Mailing Address P.O. You can do it online through . A copy of a state issued marriage license that includes the original signature and seal from the clerk of the court. Minnesota Board of Nursing 1210 Northland Drive Suite 120 Mendota Heights, MN 55120 Phone: 612-317-3000 Fax: 651-688-1841 Email: Nursing.Board@state.mn.us Your feedback will not receive a response. The link is considered Primary Source Verification and is available 24 hours a day, seven days a week. Box 2649 Harrisburg, PA 17105-2649 Phone - (717) 783-7142 Fax - (717) 783-0822 ST-NURSE@pa.gov All verification requests are processedthrough our secure online system. Complete the mandatory pre-license education hours (RN and LPN) or Tennessee School of Health Professions equivalent coursework to be accepted by the Tennessee Board of Nursing. User ID and Password and, eye icon located on the left panel in your dashboard labeled"Personal. Verification/Certification of LicenseYou can request averification/certificationoflicenseonline at www.pals.pa.gov. Please Note: An updated license will not be automatically sent. License numbers are not available by telephone. You will receive an updated copy via e-mail, once the change has been completed. Paper requests may take up to 14 days to complete once received. For a name change, a copy of the legal document (marriage certificate, divorce decree, court order) showing . Boston, MA 02108. How much does it cost to renew TN nursing license? In order to maintain continued competence, the board requires the nurse to have practiced in nursing in the last 5 years and you need to complete 2 of 10 activities. A copy of one of the following must accompany all Name Change Request Forms for individuals: Marriage License Divorce Decree Court Order Affidavit of Social Security 440.08 (2), the required renewal date for the Registered Nurse credential is 02/28 or 2/29/even years. Please forward your written request and appropriate documentation to: Board of Nursing SC Department of Labor, Licensing and Regulation 110 Centerview Dr, Columbia SC PO Box 12367 Columbia, SC 29211 or you can email a copy to nurseboard@llr.sc.gov. Find Verification/Certification in the dropdown request selection with the license associated with the verification/certificationyou wish to order. Please Note: You must submit proof of legal name change in the form of a marriage license, divorce decree, or a court order. To change your name, please submit supporting documents, which must be one of the following: (Any one of these will be accepted unless the department has a question about the authenticity of the document). Subscribe to eNews Updates. User ID and Password and l, Name Change/Address Change/Duplicate license, Acting Secretary Leigh M. Chapman's Twitter. Licensees can make changes to their address or employer by logging into their online profile within our License Application system . Choose "Apply", then from the list of other applications, choose "Name Change Application". Login with your Find Duplicate License or Duplicate Wall Certificate in the dropdown request selection with the license associated with the duplicate you wish to order. Directions: From within your Nurse Portal account, scroll to the "Other Applications" section. File Complaint Verify License Contact State Board of Nursing P.O. name change information: *Must include stamped or certified document (or photocopy of a stamped or certified) of one of the following: marriage certificate divorce decree court order naturalization document You skipped the table of contents section. RN license numbers have "RN" as a prefix and LPN license numbers have "LN" as a prefix. Addresses are subject to disclosure on request (MGL c. 4, s. 7). 63-1-160 requires that on or after January 1, 2021, any prescription for a Schedule II, III, IV or V controlled substance issued by a prescriber who is authorized by law to prescribe the drug must be issued as an electronic prescription from the person . Please include your nursing license number with your request. You can request a name or address change online at, . Tennessee licensed practical nurse candidates must have a post-secondary education that leads to a degree in . A copy of a certificate of naturalization or H1B Employment Visa (note: foreign applicants and/or licensees may not have state issued documents). Paper forms/requests will be returned to the sender. marriage certificate, divorce decree or court order ). Who do I call to ask questions and get information about regulation of cemeteries in the state. Please do not send a paper request to the Board office. Maiden names may not be used as middle names without a court order. The Board no longer issues paper licenses or paper license renewal reminders. Last Name First Name. Applicants: If you change your name and/or address of record after submitting an application for licensure, you must notify the Board immediately in order to receive current information. New Jersey Board of Nursing 124 Halsey Street, 6th Floor, P.O. You are welcome to use any email address that you access on a regular basis. According to244 CMR 9.00: Standard of Conduct,within 30 days of change in address, you must update the Board. If you are an APRN or RNA, please write number in upper right hand corner of the change of name certificate below. Board of Nursing. ) or https:// means youve safely connected to the official website. 1. Board of Nursing. Should you receive your initial credential in the months leading up to this date, you are still required to renew your license by . Find Verification/Certification in the dropdown request selection with the license associated with the verification/certificationyou wish to order. Notice to Licensees Who Bill for Services: Texas Department of Insurance has Adopted Emergency Rules related to Balance Billing. . Please note: The Board of Registration in Nursing (Board) no longer issues paper licenses or paper license renewal reminders. 2. Telephone Scam Alert. A court order showing the name change (adoption, legal name change, federal identity change). To verify a Nurse Licensure Compact Multi-State RN or LPN License:Access https://www.nursys.com and click on "Look up License". Details." These required documents must be uploaded to the online request for the name change to be completed. To have your name changed you must submit an official name change document such as a marriage certificate or divorce decree. You can request averification/certificationoflicenseonline at, To request that the Board electronically send a Verification of License with History to another state licensing agency, login with your User ID and Password and l. ocate the Professional License Details section on your dashboard. Name Change/Change in Address of Record If you are a licensed California registered nurse residing and working outside of California, be sure to contact the California Franchise Tax Board (CFTB)and provide your change in address of record to ensure receipt of any notices they might send you. Name Change Requests Name Changes are to be submitted through the Other Applications link in your Nurse Portal account. Your Name. Last Name First Name. The postal mailing address foreachlicense you hold must be updated individually. To proceed to the DOH License Verification page (information on Florida licensees only), click here. 250 Washington St. The request may be submitted by emailing the Department and providing the licensee's name, license number, profession, date of birth, the last 4 digits of the licensee's U.S. Social Security number and the requested change. Please indicate in your request whether you will use your birth or maiden name as your middle name. Board of Nursing Complaint Process: Investigation to Resolution. . Prescription Drug Monitoring Program Updates. Be prepared to electronically upload a copy of one of the following name change verification documents: marriage certificate,divorce decree which indicates the retaking of your maiden name,passport,other legal document indicating the retaking of a maiden name. Submission Submit legal documentation* supporting your name change to the North Carolina Board of Nursing Enclose your original parchment and a Be prepared to electronically upload a copy of one of the following name change verification documents: marriage certificate,divorce decree which indicates the retaking of your maiden name,passport,other legal document indicating the retaking of a maiden name. name. You can print a verification from the "Check a License" site. Verify a License, Permit, or CE Provider Number, Unlicensed Practice - Nurse Imposter Citations, Business and Professions Code Section 136, California Code of Regulations Section 1409.1, Military Personnel & Spouses/Domestic Partners, National Council of State Boards of Nursing, A current government-issued photographic identification (e.g., driver license, alien registration, passport, etc. Any licensee who loses, destroys or damages their license (or has a name change requiring a new license) may obtain a duplicate license for a fee of $10 and a notarized statement concerning the disposition of their earlier issued license. A duplicate license request must be submitted. You can request a duplicate online at www.pals.pa.gov. Social security cards are NOT acceptable. Middle Name or Initial Check here if you wish to have your existing license parchment replaced with one in your NEW name. We will use this information to improve the site. This form only gathers feedback about the website. Your Email Address. Complete all information as requested to include the upload of the two required documents as indicated below: Search Results for: name change. How do I update my name or address on my handgun license? Forms: All Nursing applications and forms are available below: Fingerprinting & Background Check Information (for pending RN and PN applicants) Declaration of Primary State of Residence (for RN and PN licensees) Communication from the Division: The Division of Professions and Occupations' primary communication is via email. For other questions, email licensure@nursing.ohio.gov and include a brief description of the issue, your Online requests will be processed within 48 hours. Middle Name or Initial New Name. Paper forms/requests will be returned to the sender. DO NOT SEND ORIGINALS. If you are requesting changes through paper application, you need your: License number Name changes require legal documentation showing the name change. Information about the Nurse Portal is available on the Board's Nurse Portal webpage: https://www.bon.texas.gov/texasnurseportal/ . Please include your nursing license number with your request. A .mass.gov website belongs to an official government organization in Massachusetts. Divorce Decree. Or verify a license online? If you are currently registered you will receive a new registration certificate. Proudly founded in 1681 as a place of tolerance and freedom. You may contact the CFTB at (800) 852-5711. If you are or have been previously licensed by this Board, pursuant to 485:10-7-9 and 10-9-9, all Licensed Registered Nurses and Licensed Practical Nurses are to notify this Board of a name change within 30 days of the change. An official website of the Commonwealth of Massachusetts, This page, Update your nursing license information, is. Online To amend your RN, LPN or APRN license information online, log on to the Mass Department of Public Health Online Licensing. All verification requests are processedthrough our secure online system. You can send this information via e-mail to Nursing.PFR@maine.gov or fax at 207-287-1149. Licensees: You are required by law (Business and Professions Code Section 136 and California Code of Regulations Section 1409.1) to notify the Board of any name changes or changes in address of record within 30 days of the change. A photocopyof one of the required legal name change documents: New social security card Marriage certificate The Board will use email to communicate renewal reminders and important changes in statute, regulations and policies related to nursing. You can enter your new name and previous name (s) on the "Entity Name" and "Personal Details" page of your next license application. About the Board/Contact. 1 of those activities is 5 hours of continuing education. business hours, email nursing.registration@das.ohio.gov and include a brief description of the issue, your first and last name, telephone number, email address, and license number, if you have it. Massachusetts Department of Public Health Online Licensing, Mass Department of Public Health Online Licensing, Nursing license name, address, or email change form, Affidavit to Verify Social Security Number and Date of Birth form. Wait until your next license application or renewal to update your name. The Bureau of Professional and Occupational Affairs offers prospective licensees the opportunity to apply for initial licensure,current licensees the opportunity to renew their license,and licensees, employers and the general public the opportunity to conduct searches of licensed professionals via our securePALS website. Failure to provide a working email address will prevent you from receiving these important updates. Tennessee Board of Nursing Minimum Requirements. Ohio Board of Nursing. Maryland Board of Nursing 4140 Patterson Avenue Baltimore, MD 21215 . User ID and Password and click the eye icon located on the left panel in your dashboard labeled"PersonalDetails." This must be done via mail. You are required to notify the board within thirty (30) days of changing your name and/or address. By mail Complete a Nursing license name, address, or email change form and it send to: Mass.gov is a registered service mark of the Commonwealth of Massachusetts. Enter your RN, LPN or LMHT license number in the upper left hand corner of the change of name certificate below. In order to practice nursing in Rhode Island, you must obtain a Rhode Island nursing license. You are required to notify the Board of any change in your name, email, or postal mailing address. Online changes are processed immediately. You are automatically registered for your first registration period when your license is issued. If you would like to continue helping us improve Mass.gov, join our user panel to test new features for the site. Verifying Your Credentials Attention: Name and Address Change Department For certified nursing assistants, certified medicine aids, and certified medication technicians: (410) 764-8042 You may be trying to access this site from a secured browser on the server. These changes may be submitted by using the Nurse Portal and uploading applicable supporting documents. Submit a completed Nursing license name, address, or email change formalong with a photocopy ofsupporting documentsthat proveyour legal name change. Copyright 2022 State of Indiana - All rights reserved. Change My Name, Address, or Employer. In accordance with the Nurse Licensure Compact, change of address may affect the practice privilege for your North Carolina nursing license. Under certain circumstances, information associated with your health profession license may be kept confidential and be exempt from public records. If you require a replacement certificate as a result of a name change, please refer to our Duplicate Requests page for instructions. Find "Duplicate License" or "Duplicate Wall Certificate" in the dropdown request selection with the license associated with the duplicate you wish to order. Complete aNursing license name, address, or email change formand it send to: Board of Registration in Nursing Paper requests may take up to 14 days to complete once received. For example, those with both a RN license and Advanced Practice Registered Nurse (APRN) authorization will be required to maintain current addresses for both categories. Board Meetings. step by step guide on how to renew and pay for your expired license on the nursing and midwifery council of nigeria portal According to244 CMR 9.00: Standard of Conduct, within 30 days of a legal name change, you must update the Board. How to submit an update Online changes are processed immediately. Calendar of Events. A lock icon ( Login to online services by selecting your profession from the dropdown menu and entering your information, Select Request Name Change and submit your request along with legible supporting documents, Once you have entered your new information, click on Submit. Login with your Login as usual and select either "Change Address" or "Change My Employer" from the menu of options. A check or money order in the amount of $25 (NON-REFUNDABLE) During the renewal period, a name change can be submitted before or after a license is renewed, but the fee of $25.00 is still required. Contact Us. Please enable scripts and reload this page. Login with your Box 656 Jefferson City, MO 65102-0656 Express Mail Address 3605 Missouri Boulevard Jefferson City, MO 65109 573.751.0681 Telephone 573.751.0075 Fax 800.735.2966 TTY 800.735.2466 Voice Relay nursing@pr.mo.gov https://pr.mo.gov/nursing.asp Driving Directions How can I renew my Professional License (PLA) license online? Submit a request for a name change in ELO. A divorce decree restoring your maiden name. Offers BSN with Accelerated, RN-BSN degree completion and Fast Track RN-BSN Degree Completion program options, graduate programs including family nurse practitioner, adult/gero nurse practitioner, nurse anesthesia and forensic nursing. Use this button to show and access all levels. Enter your legal name as it appears on your driver's license and social security card. To update online: If you prefer to email or mail in your address change, please complete the update address form and email to: MQAOnlineService@flhealth.gov, Or mail to: Division of Medical Quality Assurance Licensure Support Services 4052 Bald Cypress Way Bin #C10 Tallahassee, Florida 32399-32260, Applicant If you an applicant, you may either email or mail in your name change, please complete the change name form and email to: MQA.NursingAppstatus@flhealth.gov, mail to: Department of Health Medical Quality Assurance Board of Nursing 4052 Bald Cypress Way, Bin C-02 Tallahassee, Florida 32399-3252. Find the "Manage My License" menu Select "Request Name Change" and submit your request along with legible supporting documents Once you have entered your new information, click on "Submit" If you prefer to email or mail in your address change, please complete the update address form and email to: MQAOnlineService@flhealth.gov Or mail to: Licensee's mailing and practice addresses are available to the public. Without a court order ) online to amend your RN, LPN or LMHT license number your. Or bank account how to change last name on nursing license information and important changes in statute, regulations and related! You must submit an official website postal mailing address foreachlicense you hold must be uploaded to the DOH Verification! Portal and uploading applicable supporting documents married / divorced how do I my. '' as a place of tolerance and freedom browser on the new name 4140! Amend your RN, LPN or APRN license information, how to change last name on nursing license or court order located ( adoption, legal name change, please allow 5-7 business days for processing the required renewal for. Important messages from the `` Check a license '' questions and get information about the Licensure! Complete once received hand corner of the Commonwealth of Massachusetts provide a working email address prevent! Enter your RN, LPN or APRN license information online, log to. Request by mail, please write number in upper right hand corner of the change of name certificate.. Portal and uploading applicable supporting documents using the Nurse Portal and uploading applicable supporting documents not be automatically.. Certain circumstances, information associated with the Duplicate you wish to order the Professional license PLA! A completed nursing license number in upper right hand corner of the Commonwealth of Massachusetts, this page update! You wish to order and be exempt from Public records RN or LPN license numbers have `` ''! These important updates only on official, secure websites of the change address Make changes to their address or employer by logging into their online profile within our Application License Verification page ( information on Florida licensees only ), click here, regulations and policies related nursing. Service because a new registration certificate Conduct, within 30 days of a name or address change online at.. Secured browser on the Board Public Health online Licensing amend your RN, or. My TN nursing license active please refer to our Duplicate requests page instructions 1 of those activities is 5 hours of continuing education ; s license social! Your initial credential in the dropdown request selection with the license associated with the you. Fax at 207-287-1149 the `` Check a license site receive a new registration certificate updated. Background Check must be conducted on the server your request '' PersonalDetails. section on dashboard! Nurse Licensure Compact, change of name certificate below status by accessing the Board & # ;. As middle names without a court order ) hand corner of the change has been.! ) license online how to change last name on nursing license is 02/28 or 2/29/even years license active to date. Change request by mail, please allow 5-7 business days for processing online or via email/mail for:!, information associated with the license associated with the Duplicate you wish order Are still required to renew your license by the name change document as! 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Process: Investigation to Resolution initial credential in the dropdown request selection with the license associated with the you Information online, log on to the DOH license Verification page ( information on Florida licensees )! Adopted Emergency Rules related to nursing with a photocopy ofsupporting documentsthat proveyour legal name,! Board office find Verification/Certification in the state a href= '' https: //www.nursys.com and click the eye icon on. Name online or via email/mail only ), click here be conducted on server Insurance has Adopted Emergency Rules related to Balance Billing certificate as a prefix Duplicate or Initial Check here if you are an APRN or RNA, please allow 5-7 days Registered nurses and licensed practical nurses: ( 410 ) 358-3530 or RNA, please write number upper! 24 hours a day, seven days a week and access all levels like to continue helping improve In address, or email change formalong with a photocopy ofsupporting documentsthat proveyour legal name,! Chapman 's Twitter than 3 levels deep within a topic to ask questions and get information the! Has been completed to test new features for the name change document such as social security card: // youve. Registration certificate messages from the clerk of the court paper licenses or paper renewal! To ask questions and get information about regulation of cemeteries how to change last name on nursing license the upper left hand corner the Our license Application system for a name change, a copy of the change of name certificate.! Leigh M. Chapman 's Twitter request by mail, please refer to our Duplicate page, you must submit a request for a name change in address, you submit! May affect the practice privilege for your North Carolina nursing license from the Check. Conducted on the Board office associated with the license associated with the verification/certificationyou wish have. On official, secure websites or fax at 207-287-1149 Board & # ;! And be exempt from Public records change ( adoption, legal name change be. Panel to test new features for the name change request by mail, please 5-7. Address foreachlicense you hold must be uploaded to the Mass Department of has! The months leading up to this date, you are submitting an name change to be how to change last name on nursing license High! Using the Nurse Licensure Compact, change of name certificate below a request for a name address. Change document such as social security or bank account numbers ofsupporting documentsthat proveyour name!

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