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                Get Mn X14894 2005
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How to fill out the MN X14894 online
The MN X14894 form is a Minnesota Uniform Credentialing Application for healthcare professionals. This guide provides clear, step-by-step instructions on how to effectively complete this important document online.
Follow the steps to successfully complete the MN X14894 online.
- Click ‘Get Form’ button to obtain the form and open it in the editor.
 - Begin by entering your full name in the spaces provided, ensuring to include your last, first, and middle names. Add any suffix if applicable.
 - For credentialing contact information, fill in your current address, phone number, and email. Make sure all details are accurate and legible.
 - If applicable, Allied Health Professionals should provide their profession/title and the name of the sponsoring or collaborative physician.
 - Enter personal data including date of birth, gender, U.S. citizenship status, and social security number. Double-check the accuracy of your home address.
 - Describe your primary or pending practice location. Include the clinic name, address, and office phone number. Indicate if you are currently practicing at this location.
 - List all relevant medical and professional education details. Ensure to include institution names, dates, and degrees received.
 - Complete your chronological employment/practice history. Include any gaps in service greater than three months and provide explanations where necessary.
 - Fill in details for specialty/subspecialty certifications, including certifying boards and expiration dates.
 - Finally, review the form for completeness and accuracy. Save changes, and download or print a copy of the completed MN X14894 before submission.
 
Complete your documentation online today to ensure a smooth application process!
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