License and Registration Information
CredentialLicense TypeOriginal IssueIssue DateExpiration DateStatusDisciplineHow issuedDescription
COA.16579-NS Clinical Nurse Specialist 09/18/2014 05/26/2015 08/31/2017 ACTIVE
CTP.16579-EX1 Prescriptive Authority - Externship 11/10/2014 11/10/2014 11/10/2015 CLOSED
CTP.16579- Prescriptive Authority 11/10/2014 10/13/2015 08/31/2017 ACTIVE
Registered Nurse Applicant - Examination CLOSED Examination
RN.344723-1 Registered Nurse-1 Certificate of Authority 09/02/2008 05/26/2015 08/31/2017 ACTIVE Examination
License and Registration Information (cont.)
If you have already received your ATT from Pearson VUE, the information in the section below has already been received by the Board. The application requirements below will indicate the status of the requirement.
CredentialBackground CheckCitizenship VerificationEducation VerificationForeign Nurse RequirementPay Pearson VUE
License and Registration Information (cont.)
CredentialSpecialty 1Certifying Org 1Certifying ExpDate 1Specialty 2Certifying Org 2Certifying ExpDate 2Specialty 3Certifying Org 3Certifying ExpDate 3
COA.16579-NS NS - OTHERAACN8/31/2019
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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