Example: tourism industry

Phone Fax Date

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PENNSYLVANIA STATE BOARD OF NURSING PHONE (717) …

PENNSYLVANIA STATE BOARD OF NURSING PHONE (717) …

www.dos.pa.gov

Check the expiration date on your current license. Then find the date in the table when your CE is due. 1) Look for CE offerings from Board-approved providers occurring in the time frames indicted in (*) the table below for your expiration date. For example: If your license will expire on April 30, 20you will need to complete 30 hour20 s of

  Date, Phone

Precertification FAX Request Form - CONFIDENTIAL

Precertification FAX Request Form - CONFIDENTIAL

medikeeper.blob.core.windows.net

Precertification FAX Request Form - CONFIDENTIAL ... must be called into Medical Management: Employer Group Phone Number Fax Number . AAA Oregon/Idaho 877-379-4839 877-253-9553 Academy Sports 855-778-9046 888-283-2821 AK-Chin Indian Community 855-240-3693 855-501-3685 ... Requested Date(s) of Service or date range: _____ ...

  Date, Phone

PRIOR AUTHORIZATION FAX COVER SHEET

PRIOR AUTHORIZATION FAX COVER SHEET

swhp.org

FAX: 800-626-3042 PHONE: PHONE: 888-316-7947 FAX: PAGES: pages including coversheet DATE: RE: PRIOR AUTHORIZATION REQUEST INSTRUCTIONS: Use this fax cover sheet with the Texas Standard Prior Authorization Request for Health Care Services Form to …

  Date, Phone

PHONE: IRP (503) 378-6643 OREGON APPLICATION FOR IRP …

PHONE: IRP (503) 378-6643 OREGON APPLICATION FOR IRP …

www.oregon.gov

phone: irp (503) 378-6643. ifta (503) 373-1634 fax: irp (503) 378-5765. ifta (503) 378-5765. signature. oregon department of transportation commerce and compliance division 3930 fairview industrial drive se salem or 97302-1166 form 735-9908 (9-20) effective date. ccd account number previous ccd account no.

  Date, Phone, Oregon

Phone: 919-855-3969 Raleigh, NC 27699-2709 Center for Aide ...

Phone: 919-855-3969 Raleigh, NC 27699-2709 Center for Aide ...

www.ncnar.org

Phone: 919-855-3969 Fax: 919-733-9764 Division of Health Service Regulation N.C. Health Care Personnel Registry Section N.C. Department of Health and Human Services For assistance, contact registry staff at 919-855-3969, weekdays, from 8 a.m. - 12 noon and 1 p.m. - 3 p.m., or visit www.ncnar.org. Supervisor Instructions - Page 2

  Phone

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