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Get Name And Address Change Form - North Carolina Board Of Nursing
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How to fill out the Name And Address Change Form - North Carolina Board Of Nursing online
Updating your name and address with the North Carolina Board of Nursing is an important step in maintaining your professional records. This guide will provide you with clear instructions on how to fill out the Name And Address Change Form online, ensuring a smooth and efficient process.
Follow the steps to complete your form accurately
- Press the ‘Get Form’ button to access the Name And Address Change Form and open it in your preferred editor.
- Begin by locating your RN or LPN certificate number, and if applicable, your NA II listing number. These numbers help in processing your request.
- Clearly print your new name in the designated field, ensuring you include your first, middle, and last name without any nicknames.
- Fill in your new street address, city, state, and zip/postal code. Accurate information is crucial to ensure proper updates in the Board’s records.
- Next, provide your date of birth and social security number. This information assists in verifying your identity.
- Sign the form where indicated, and provide your daytime phone number and email address for any necessary follow-up.
- If you are an RN or LPN, you must indicate your primary state of residence and whether you are on active duty as an Armed Forces Nurse or employed in a Federal Facility.
- After completing the form, prepare a photocopy of a document that verifies your new legal name, such as a driver’s license or marriage license.
- Lastly, you can now save changes, download the completed form, print it, or share it as needed, and send it along with the required document to the North Carolina Board of Nursing.
Ensure your records are up to date by completing your Name And Address Change Form online today!
A completed online application. A criminal background check. ... Proof of successfully completing a licensed nursing program. Proof of passing the NCLEX. Documentation of having met the continuing education requirements. A license endorsement fee of $150.00.
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