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Professional Credentialing
 
Click on the link below to print our standard therapist application for states without a mandated form. RPN will also accept state-specific applications printed from CAQH with an attestation signature less than 60 days old. Fax the appropriate Application for your state to (919) 878-8871.
 
RPN Credentialing Application 2014
  NC Uniform Application 2005
  OH Credentialing Application
  Instructions to print CAQH application