CREDENTIALS OF EMERGENCY DEPARTMENT PHYSICIANS
List each Nurse Practitioner and/or Physician Assistant by name. Indicate full time or part time and date of ED hire. Check all credentials and verify current license. Nurse Practitioners shall have completed a Pediatric NP, Emergency NP or Family Practice NP program (or meet waiver criteria identified in 515.4000 or 515.4010, b, l, A, i). ................
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