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[DOCX File]lewis.gsu.edu
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For the purpose of establishing Georgia residency for tuition and fee payment, your legal residence is your permanent home. Not only must you live in Georgia but you must remain i
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[DOCX File]GEORGIA ASSOCIATION FOR NURSING EDUCATION, INC
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Currently enrolled in an accredited program in nursing. Resident of Georgia. Verifiable financial need. GPA of at least 2.5 on 4.0 scale in prior educational work . All non-RN applicants must have completed one year of study. Provide two letters of reference which indicate leadership, scholarship and potential for success in the practice of nursing. Priority will be given to applicants who ...
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[DOC File]Private Duty Nursing Services Section II
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Private Duty Nursing Services (PDN) providers must meet the Provider Participation and enrollment requirements contained within Section 140.000 of this manual as well as the following criteria to be eligible to participate in the Arkansas Medicaid Program: A. The PDN provider must have either a Class A or Class B license issued by the Arkansas Division of Health. It must be designated on the ...
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[DOC File]CNA SCHOOL CONTRACT
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To view state registry, go to www.mmis.georgia.gov. You will receive your State Certification card about 2-4 week after you pass your exam. Patient Care Technician (PCT) - Advanced Nursing Skills, with an emphasis on Phlebotomy & EKG. Objective . The PCT program includes training in Advanced Nursing Skills, EKG and Phlebotomy. This training ...
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[DOC File]UB-04 Completion: Outpatient Services (ub comp op)
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This field is mandatory for radiologists. If the physician is not a Medi-Cal provider, enter the state license number. Do not use a group provider number. The referring or prescribing physician’s first and last names are not required by Medi-Cal. Note: Providers billing lab service for residents in a Skilled Nursing Facility (NF) Level A or B are required to enter the NF-A or NF-B as the ...
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[DOC File]healthprofessions.gsu.edu
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Students must be accepted and enrolled in the university’s undergraduate nursing, nutrition, or respiratory therapy programs. Pre-nursing, pre-nutrition, or pre-respiratory therapy students are not eligible for the scholarship. Students agree that they are Christian women. Students must have permanent residency in one of the states specified by the Foundation (Georgia, North Carolina, South ...
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[DOC File]UHPCAF Part 1
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Permanent Resident Card or Visa Status (if applicable) Military Discharge Record (Form DD-214) (if applicable) Name of Healthcare Entity to which you are submitting this Application: For what type of relationship (i.e., staff membership, network participation, etc.): GEORGIA UNIFORM HEALTHCARE PRACTITIONER CREDENTIALING APPLICATION FORM *****PART ONE***** If more space than is …
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[DOCX File]303 - MSP/ABD
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He mails a completed, signed application to the local office along with a copy of his driver’s license. It is received on July 5. He alleges his only income for the year has been $750 per month in Social Security. Alleged resources are a checking account, an irrevocable pre-need burial contract worth $6,500, and a 2010 Toyota. A $7,000 CD matured in May, was deposited into the checking ...
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[DOC File]Recre
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State Professional License(s) Federal Narcotics License (DEA Registration) Specialty/Subspecialty Board Certification or letter from Board(s) stating your status. Declaration Page (Face Sheet) of Professional Liability Policy or Certificate of Insurance. Permanent Resident Card or Visa Status . Military Discharge Record (Form DD-214)
ga professional license print card

[DOC File]Dear Applicant
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a. GA Driver’s License. b. State of GA Identification Card. c. GA birth certificate . d. Voter’s Registration Card, OR. e. Georgia Medicaid Card (If you are a Georgia Medicaid Patient, please attach a copy of the Georgia Medicaid Card with your application) 2. Proof of Residency (Please provide one of the following): Lease Contract (if renting) Mortgage Statement if you own your home ...
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Print georgia nursing license card