License and Registration Information
CredentialLicense TypeOriginal IssueIssue DateExpiration DateStatusDisciplineHow issuedDescription
COA.07618-NP Certified Nurse Practitioner 11/06/2003 06/26/2015 08/31/2017 ACTIVE
CTP.07618- Prescriptive Authority 03/21/2005 06/26/2015 08/31/2017 ACTIVE
CTP.07618-EX2 Prescriptive Authority - Externship Extension 01/20/2005 01/20/2005 01/20/2006 INACTIVE
CTP.07618-EX1 Prescriptive Authority - Externship 01/20/2004 01/20/2004 01/20/2005 INACTIVE
RN.239436-1 Registered Nurse-1 Certificate of Authority 09/11/1992 06/26/2015 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
COA.07618-NPNP - FAMILYANCC10/31/2018
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.


search At least 3 letters.