Nurse Practioner Form 2B - New York State Education Department

New York State DMV ID Number) 7. Print name under which course was completed (if different from above) 8. ... NY 12234-1000. OR, Submit this form to the Department by E-mail at DPLSEduc@nysed.gov. Nurse Practitioner Form 2B, Page 2 of 2, Revised 9/20. Title: Nurse Practioner Form 2B Author: NYSED Office of the Professions ................
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