License and Registration Information
CredentialLicense TypeOriginal IssueIssue DateExpiration DateStatusDisciplineHow issuedDescription
COA.06746-NM Certified Nurse MidWife 11/21/2001 08/14/2015 08/31/2017 ACTIVE
CTP.06746- Prescriptive Authority 10/18/2005 08/14/2015 08/31/2017 ACTIVE
CTP.06746-EX1 Prescriptive Authority - Externship 11/30/2004 11/30/2004 11/30/2005 INACTIVE
CTP.06746-EX2 Prescriptive Authority - Externship Extension 05/20/2002 07/28/2003 05/20/2004 LAPSED
RN.274303-1 Registered Nurse-1 Certificate of Authority 10/11/1994 08/14/2015 08/31/2017 ACTIVE Examination
License and Registration Information (cont.)
CredentialSpecialty 1Certifying Org 1Certifying ExpDate 1Specialty 2Certifying Org 2Certifying ExpDate 2Specialty 3Certifying Org 3Certifying ExpDate 3
Effective February 1, 2011, the Board will require primary source verification for advanced practice nurse national recertification. For this to occur, an advanced practice nurse must request that their national certifying organization notify the Board directly of national recertification within thirty days of their recertification. The Board will no longer accept documentation of recertification directly from a COA holder.


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