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Physician Application
Apply to Join APRN Match as a Collaborating Physician
Full name
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Phone number
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Email address
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Medical Specialty
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State(s) of Licensure
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State(s) of Licensure
NPI number
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Are you currently supervising any NPs
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Are you currently supervising any NPs
Yes
No
Maximum number of NPs you are open to collaborating with?
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Preferred Collaboration Type
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Preferred Collaboration Type
Upload CV or LinkedIn Profile
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Click to choose a file or drag here
Size limit: 10 MB
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I understand that APRN Match facilitates collaborations and that compensation will be arranged per signed agreement
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I understand that APRN Match facilitates collaborations and that compensation will be arranged per signed agreement
Yes
Submit