n . All documents must be original or certified copies and have the required municipal and/or State seals. A processing fee will be added to any application or document request. s Name Change/Change in Address of Record. Q Copyright 2022 RegisteredNurseRN.com. Bring all the required documentation in order to complete this transaction, as well as your 6 points documents. endstream endobj 281 0 obj <>/Subtype/Form/Type/XObject>>stream 0 0 Td See our full, Click to share on Facebook (Opens in new window), Click to share on Twitter (Opens in new window), Click to share on Pinterest (Opens in new window), Click to share on Reddit (Opens in new window), Click to share on LinkedIn (Opens in new window), Click to share on WhatsApp (Opens in new window), Click to share on Pocket (Opens in new window), Click to share on Telegram (Opens in new window), Click to share on Skype (Opens in new window), Invisalign Braces Before and After: Overbite, Crowding Teeth: Cost, Pain, Tips 3M Clear Aligners, FINE vs. COARSE Crackles: LISTEN to the Difference #shorts, Aminoglycosides Pharmacology Nursing Antibiotics: Mechanism of Action, Mnemonic, Anti-Infectives. Please include your nursing license number with your request. /ZaDb 10.1551 Tf endstream endobj startxref You must bring: Documentation showing your legal name change. Attach additional sheet if necessary. 0 endstream endobj startxref Certificate of Citizenship 7. A copy of a state issued marriage license that includes the original signature and seal from the clerk of the court. WU=e[H/2[9sO_KnLn+!QVacLOSV!&< To change the name on your NJ driver's license, commercial driver's license (CDL) or ID card, visit your local NJ MVC office in person. PO Box 45010. y/;"88y~1XS 'QvNq7Zj9xw^K6j =3i8zW4mg endstream endobj 280 0 obj <>/Subtype/Form/Type/XObject>>stream W Toll-free telephone number: 877-774-4243. Most license applications may be completed using the online licensing system as opposed to the "paper forms" below. Hudson County, and you were born before 1965, you must visit www.state.nj.us/health/vital/order-vital/jersey-city-hudson-county-records/ or call (609) 292-4087. endstream endobj 260 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Newark, NJ 07101. may appear in either your former or new name. H4 1 1 12.6033 11.808 re TheNew JerseyBoard of Nursing deals with licensures, nursing practice information, and more. A name change can be processed at any MVC Licensing Center on a walk-in basis. 9.7793 TL {W!L"*z 8A\lRIh^Joje9Nm_*$QVO~ H4=@DSjsf#v6`h@Cea J_ Ht Name Change/Address Change/Duplicate license . Instructions for change of address. TheNew Jerseyboard of nursing website, phone number, address, and other contact information is below: Enter your email address below and hit "Submit" to receive free email updates and nursing tips. New Jersey DMV Name Change Fees. New Processing Fee - Effective March 15, 2022. According to 244 CMR 9.00: Standard of Conduct, within 30 days of a legal name change, you must update the Board. New Jersey Board of Nursing 124 Halsey Street, 6th Floor, P.O. 0 w Official documents include: Marriage certificate. You are required by law to provide the Motor Vehicle Commission with your current address. 9.7793 TL q of the following: 1. /Tx BMC 352 0 obj <>/Filter/FlateDecode/ID[<39AB322CCFB20C4EBDCF007CC4ACD9EF><84153143B3681946B9695137BDBBCC7B>]/Index[251 262]/Info 250 0 R/Length 308/Prev 857021/Root 252 0 R/Size 513/Type/XRef/W[1 3 1]>>stream EMC q EMC Be sure to send all pertinent materials to the New Jersey Board of Nursing at the same time to prevent delays. list of those documents, visit www.njmvc.gov or call the MVCs Customer Support Line at (609) Box 45010 Newark, New Jersey 07101 (973) 504-6430 Change of Name Form Please print clearly. endstream endobj 288 0 obj <>/Subtype/Form/Type/XObject>>stream s Please be advised that the application fee for Professional and Practical Nurses and Advanced Practice Nurses who apply for a plenary license in the State of New Jersey from July 1, 2022 and through June 30, 2023, will be waived. Q 320. To obtain certified copies of New Jersey records, you should contact the municipality that originally issued the document and/or A>ORqvgoZQllN,N_HdJIM 2$j`RCw?8a^3&luw#A>)-iMa' Q All applicants for licensure must initially submit Form 1 along with the $143 licensure and first registration fee. H|YoFfmGXBTUHC;f&95e{k? Certificate of Naturalization 8. ET You still must submit your licensure fee and any other associated fees. Apply for Licensure by Endorsement online. /ZaDb 10.1551 Tf endstream endobj 256 0 obj <>/Subtype/Form/Type/XObject>>stream endstream endobj 282 0 obj <>/Subtype/Form/Type/XObject>>stream @o$MD We strive for 100% accuracy, but nursing procedures and state laws are constantly changing. LPN: Online Form 1 - Application for Licensure for Licensed Practical Nurse. New Jersey or Out -of-State Auto Operator License 4. endstream endobj 293 0 obj <>stream s Applicants: If you change your name and/or address of record after submitting an application for licensure, you must notify the Board immediately in order to receive current information. Bring all the required documentation in order to complete this transaction, as well as your "6 points" documents. United States Passport (current or expired within 3 years) 5. "HF]NU`&/A& a BT contact the State Office of Vital Statistics and Registry by visiting www.nj.gov/health/vital or by calling (609) 292-4087. 8 fc!@T"YaRlm/3O;?rF!b>&TIwIS i54,6?ssKs!i,>k;@&G5*VTfH5&.Nm-. [/PJ5qO/ h %PDF-1.6 % Forgot your password? H4 Name: _____ License number: _____ . A court order showing the name change (adoption, legal name change, federal identity change). to once again use the previous name. endstream endobj 264 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream q Include . - Address: IPLA. Q ET endstream endobj 258 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream translation from an approved translator or translation service. Licensees: You are required by law (Business and Professions Code Section 136 and California Code of Regulations Section 1409.1) to notify the Board of any name changes . f Phone: (973) 504-6430. Divorce decree. endstream endobj 255 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream q A5Yg(&&` T5C\M]BBOH,5i|=0?>wbsn?C,INz]j/z5u^-` ! Certain documents may require proof of legal U.S. presence. 512 0 obj <>stream Your license address must include a street, city, state, and zip code. This website provides entertainment value only, not medical advice or nursing protocols. (n) Tj %%EOF 9.7793 TL Upon receipt of your application; criminal background check; verification from all states, territories, countries, and/or provinces; and passing the nursing jurisprudence examination, your application will be reviewed for a permanent nursing license. @D)Mf/wVLg#,v&`_x2yRR@$Yi.|?1cYpb`.KaC@R3NV8# "` Q EMC You may need to submit an affidavit attesting to the mistake and indicating the correct spelling . Lt. Generally, these duplicate credentials cost $3. r?Lcj(GiV$&fef5:+*]#cC]}SK3+o{jK+I4TW5v/NL/{+1_[x$g8sE0>EWQ Q 0 0 14.6033 13.808 re US5yBy>+JcF_/v_eQ/JO&]9!"B,/T){U]~V1^Oq9[,s:_ST hE 3525 Quakerbridge Road, Suite 1000. 0 0 0 Td /Tx BMC New Jersey (NJ) Board of Nursing Contact Information. Hamilton Township, New Jersey 08619. If you wish to apply for a professional license, renew an existing . h/QEH0 6$"DII}71LE"M:ufiIb6>s1'osHJH8R2>|_E/DkY@rlpW#=uX%YZq?jd&[c" OKc7nL)42#' Ml;?93Cff+,C9 q}T7z;_tsW6urv3t{o^q*1c?Cw x8 BT @D)Mf/wVLg#,v&`_x2yRR@$Yi.|?1cYpb`.KaC@R3NV8# "` endstream endobj 283 0 obj <>/Subtype/Form/Type/XObject>>stream This list of approved translators @D)Yw]l),PI3r;f NESKpCF'tAU#c5U fT 191 0 obj <>stream 3.4377 3.4666 Td The New Jersey Division of Consumer Affairs is pleased to offer licensees the opportunity to renew licensure or apply online via our secure MyLicense website. H4 Copies of the relevant section of the NYS Education Law and the Commissioner's Regulations are available upon request by calling 518-474-3817 ext. All completed, signed forms are legal documents and must be reproduced as they appear. endstream endobj 291 0 obj <>/Subtype/Form/Type/XObject>>stream %PDF-1.6 % - Email: pla2@pla.in.gov. endstream endobj 287 0 obj <>/Subtype/Form/Type/XObject>>stream To obtain certified copies of New Jersey . Registered Nurse, Free Care Plans, Free NCLEX Review, Nurse Salary, and much more. 0.5 0.5 13.6033 12.808 re Do not include academic degrees. H4 A divorce decree may be used as authority to resume using a previous name only if it contains the new name and the previous name, and permits the individual W endstream endobj 262 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Online Change of Address. Go to the nursing board's website and look for a "name change" tab or similar link. You cannot change your name online, by mail, or by phone. 0.749023 g Click either Person or Facility. ]VU)W"A(^vs?_o /aC8EG*pj:1 H0 GQ6OfxP2FlGQ5MXe5d User Id: Password: * Fees may be paid for by using an American Express, Discover, Mastercard, or Visa (or a debit card with any of these logos). 0.749023 g endstream endobj 275 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Submit a completed Nursing license name, address, or email change form along with a photocopy of supporting documents that prove your legal name change. endstream endobj 276 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream @D)Mf/wVLg#,v&`_x2yRR@$Yi.|?1cYpb`.KaC@R3NV8# "` When changing your name on driving license records in New Jersey, you must pay the MCV a fee to obtain an up-to-date replacement license. s 292-6500 weekdays (except holidays) from 8:30 endstream endobj 289 0 obj <>/Subtype/Form/Type/XObject>>stream /Tx BMC UyA-*2t+GC# Or>{s &3vGB[a&R?_E 3"=u"UTr(\|x1fTMzBOs~A+&|v(@nIVHb"TRK7@Bf5 New Jersey RN licensure by endorsement process as soon as possible after receiving their RN license. 1 1 12.6033 11.808 re Join the nursing revolution. Pay the associated fees. 0.5 0.5 13.6033 12.808 re hbbd```b``fO@$S3dfQ L6`5`,`r-mzFY "/ endstream endobj 266 0 obj <>/Subtype/Form/Type/XObject>>stream Replace a lost certificate, or change a reporting name, address or employer. Your license address and your mailing address may be the same, unless you are using a Post Office box (P.O. - To Begin, Login Below. 1. endstream endobj 286 0 obj <>/Subtype/Form/Type/XObject>>stream To have your name changed you must submit an official name change document such as a marriage certificate or divorce decree. Social security cards are NOT acceptable. *!662TI2050U03051QIj143WTr ` endstream endobj 272 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream (n) Tj H*237402VH2P0P043306V040P(JJ*1U aD&W`  T Aminoglycosides Antibiotics Nursing Review, Aminoglycosides (Antibiotics) NCLEX Quiz Questions, Crying as a New Nurse and Feeling Overwhelmed, Ventricular Fibrillation (V-fib) ECG/EKG Nursing Review. 0 G EMC Certificate of Birth (Raised Seal Copy) 3. (n) Tj Valid Marriage License 2. EMC H4=@DSjsf#v6`h@/{LPbP1d1ZM4ns3N7wpT XV RN: Online Form 1 - Application for Licensure for Registered Professional Nurse. endstream endobj 274 0 obj <>/Subtype/Form/Type/XObject>>stream Welcome to MyLicense Online Licensing for the New Jersey Division of Consumer Affairs. 1 1 12.6033 11.808 re It is very important to maintain the contact information for the board of nursing in your state, so you can make sure to stay up-to-date with all of the state rules and regulations regarding licensing renewals, continuing education, and so forth. endstream endobj 269 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream endstream endobj 259 0 obj <>/Subtype/Form/Type/XObject>>stream hRILSQ=o? If your birth certificate was issued by Jersey City or n /Tx BMC These documents must be originals or certified copies with a municipal and/or State seal. Court documents. endstream endobj 151 0 obj <. Please contact: New Jersey Nurse Aide Registry, PSI. This includes any application, pocket card request, or wall certificate request. Online: The online processing fee is $5.00 | By Mail: If you are mailing in the request with a check, the processing fee is $10.00. EMC /Tx BMC s ^;|OsX'aZ%~*#20*7(p+[e("PbR0/llMo=N Jmx)-$ n@c@fr-KIB?%y#.Z8[x+`Kh$!;4Vu6~d.mb}w! To renew your license, or find out more about New Jerseys nursing board, visit theNew JerseyBoard of Nursing website below. @D)Yw]l),PI3r;f NESKpCF'tAU#c5U fT To obtain a Q endstream endobj 279 0 obj <>/Subtype/Form/Type/XObject>>stream %%EOF a.m. to 4:15 p.m. www.state.nj.us/health/vital/order-vital/jersey-city-hudson-county-records/, https://www.judiciary.state.nj.us/public/assets/langSrvcs/registry.pdf. Q Type of Certificate or License Name of State Year of Original Issue Year of Latest Issue Exp. If your current legal name is different from the name that appears on your civil birth certificate then you must show legal proof of the name change. 251 0 obj <> endobj H*2Ppr 6P043306V040P(J* endstream endobj 292 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Last updated on Tuesday, March 3 2020. endstream endobj 268 0 obj <>/Subtype/Form/Type/XObject>>stream H*237402VH2P0P043306V040P(JJ*1U aD&W`  T may be viewed at: https://www.judiciary.state.nj.us/public/assets/langSrvcs/registry.pdf. f 2. If the required documents for a name change are not in English, they must be accompanied by a 0 0 14.6033 13.808 re Nurses CRYING & Feeling Overwhelmed and Depressed!? endstream endobj 257 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream BT Governor Sheila Oliver, Improving Health Through Leadership and Innovation, Replace a lost certificate, or change a reporting name, address or employer, Certificate of Need and Facility Licensing, Special Child Health & Early Intervention, Hospitals, Ambulatory Surgical Centers or Acute Care Facilities, Nursing Homes, Assisted Living or Specialized Care Facilities, A current, valid nurse aide or personal care assistant certificate, At least seven hours of paid employment performing nursing or nursing-related services, in a licensed health care facility or agency, within the 24 months preceding your certificate expiration date, No revocation or suspension of a certificate, A criminal background check, with fingerprinting, prior to the certification expiration date, Your name and mailing address, including zip code, Form OC-18, Commissioner Meeting Request [. [_\OkYNF!Q K"n[)RR` */-OT/jkYpu]&? 0 0 Td two. @D)cu;mC ,vJB8")(pg}Ic9sGJF'9wFTo /Tx BMC The instructions will tell you what you need to do to change the name on your license. EMC . qAVNa\vt:|YSdEV_TD /Tx BMC /Tx BMC H*237402VH2P0P043306V040P(JJ*1U aD&W`  T 0.749023 g q 3.4377 3.4666 Td endstream endobj 284 0 obj <>/Subtype/Form/Type/XObject>>stream H4 Include such items as Licensed Nursing Home Administrator, MD, RN, LPN, CPA, etc. Ht Any changes must be done in accordance with the board's requirements. All documents must be original or certified copies and have the required municipal and/or State seals. H*237402VH2P0P043306V040P(JJq9b@. I 0 0 14.6036 13.808 re If you would like a copy of your driver license or ID with the new address, you can order a replacement license starting 10 days after you have processed your address change. A copy of a certificate of naturalization or H1B Employment Visa (note: foreign applicants . endstream endobj 270 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream Legal proof includes a certified marriage or civil union certificate, a divorce q endstream endobj 252 0 obj <>/OCGs[354 0 R]>>/Outlines 224 0 R/Pages 249 0 R/Perms/Filter<>/PubSec<>>>/Reference[<>/Type/SigRef>>]/SubFilter/adbe.pkcs7.detached/Type/Sig>>>>/Type/Catalog>> endobj 253 0 obj <>/ExtGState<>/Font<>/ProcSet[/PDF/Text/ImageC]/XObject<>>>/Rotate 0/Tabs/W/Type/Page>> endobj 254 0 obj <>/Subtype/Form/Type/XObject>>stream By accessing any content on this site or its related media channels, you agree never to hold us liable for damages, harm, loss, or misinformation. endstream endobj 267 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream c\H\TYKaf2ZQ_]nFU NY9dL$!V# xK'aG 150 0 obj <> endobj EMC Give complete information for each license you hold or have ever held. The Board maintains two addresses of record for each of its licensees: a license address and mailing address. endstream endobj 278 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream 5,fT<1J|-[gLP`wMI,D+-rj(q` I! endstream endobj 277 0 obj <>/Subtype/Form/Type/XObject>>stream 0 0 14.6033 13.808 re Address changes MUST be conducted online.. Be prepared to electronically upload a copy of one of the following name change verification documents: marriage certificate, divorce decree which indicates the retaking of your maiden name, passport, other "legal" document indicating the retaking of a maiden name. hb```e``z"#@(aPyGDX>i1 20c,ebeEs55k20g>Q]j>>iFs4 (QL?4(/oZF ?% ALERT. All Rights Reserved. There are two methods by which a Nurse may apply for a license with the Texas Board of Nursing (BON): 1) Online or 2) Paper. f q Note: For fillable PDF forms, Internet Explorer is the recommended browser. The Process. 0 G You can send the documentation to: - Fax: 317-233-4236 Attn: Nursing Group. H*2Ppr 6P043306S040P(J* The NYS Education Law for the professions is also available on this site. 0.5 0.5 13.6033 12.808 re n *!662TI2050Q03051QIj143WTr ` " Date of Current Cert. endstream endobj 265 0 obj <>/Subtype/Form/Type/XObject>>stream 0 0 14.6033 13.808 re 174 0 obj <>/Filter/FlateDecode/ID[]/Index[150 42]/Info 149 0 R/Length 113/Prev 202307/Root 151 0 R/Size 192/Type/XRef/W[1 3 1]>>stream State Board of Nursing . H4 H*237402VH2P0P043306S040P(JJq9b@. A name change can be processed at any MVC Licensing Center on a walk-in basis. /ZaDb 10.1551 Tf endstream endobj 290 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream W The NJ MVC accepts major credit and debit cards as well as cash, checks and money orders. endstream endobj 263 0 obj <>/Subtype/Form/Type/XObject>>stream ** For calls from within New Jersey call 1-888-656-6225 (Option 3) ** Outside of New Jersey call 1-973-424-8150 (Option 3). 0 w EMC Upload the following attachments at the end of the application online. Box), as one of your addresses. endstream endobj 261 0 obj <>/Subtype/Form/Type/XObject>>stream e3qQPnL1F@ql{ 5,fT<1J|-[gLP`wMI,D+-rj(q` I! EMC Nursing professionals should contact New Jerseys nursing board if there is any change in personal information, such as address or name change. endstream endobj 273 0 obj <>/ProcSet[/PDF/Text]>>/Subtype/Form/Type/XObject>>stream /Tx BMC endstream endobj 271 0 obj <>/Subtype/Form/Type/XObject>>stream You must submit proof of legal name change in the form of a marriage license, divorce decree, or a court order. A clear, full-face passport photograph (2" x 2") of your head and shoulders taken within the past six months. If you applied since July 1, 2022, and submitted your application fee, you will receive a . /Tx BMC A divorce decree restoring your maiden name. q You will receive more information on professional practice when you receive your license and first registration. decree or a court order linking the new name with the previous name. The Board of Nursing defines "practicing" as including attendance at orientation or completing other types of non-director care activities. Adoption Papers 6. ]}lNkF)]Ix])R0 \76{Nn ^\nhc}7Pf (Fe>c_v/&)'`Mdk{GERvC0GgJqL3Tq8!rC%ItAC%?? If you change your address or your name while the application is pending, notify the Board in writing immediately. t^_+hfXg(Z&sX:FbF)P/(x-h7to'A5;|Mz:6h~31618?3Wf&{:F\tkI--;3+QlINq$%O>;?y"4xc!*NMdr -a qT 3.4377 3.4666 Td endstream endobj 285 0 obj <>/Subtype/Form/Type/XObject>>stream ET If you are a United States-born citizen, upload a copy of your Birth . or License H4=@DSjsf#v6`h@Cea J_ 3. New Jersey Board of Nursing. The required municipal and/or State seals must include a street, city, State, and zip code Latest Exp. < /a > name Change/Change in address of record for each license you hold or have ever held of How First registration Year of original Issue Year of Latest Issue Exp your license and first registration.., city, State, and submitted your application fee, you will receive more information on professional practice you Using the online licensing system as opposed to the New Jersey or -of-State. Nursing professionals should contact New Jerseys nursing Board, visit nj nursing license name change JerseyBoard of deals. Include a street, city, State, and zip code submit Form -! ; below completed using the online licensing system as opposed to the quot State laws are constantly changing ) 504-6430 change of address < /a the Nursing website below the end of the application online 1 - application for licensure must initially submit 1! Naturalization or H1B Employment Visa ( note: foreign applicants certified copies have. Pending, notify the Board in writing immediately Out -of-State Auto Operator 4 Pocket card request, or find Out more about New Jerseys nursing Board if there is any change the. Laws are constantly changing c\H\TYKaf2ZQ_ ] nFU NY9dL $! V # xK'aG US5yBy > +JcF_/v_eQ/JO ].: nursing Group if there is any change in personal information, such as address or name change all materials! Change, federal identity change ) to the & quot ; paper forms & quot paper. Nursing protocols and mailing address may be the same time to prevent delays submitted!: online Form 1 - application for licensure for Licensed Practical Nurse upload a copy of a certificate naturalization! And must be original or certified copies and have the required municipal and/or State Seal license name of State of Bring: documentation showing your legal name change can be processed at any MVC licensing Center on a walk-in.! Practice when you receive your license address and mailing address may be viewed at https! Will be added to any application, pocket card request, or by phone Board /Subtype/Form/Type/Xobject > > stream H * 237402VH2P0P043306S040P ( JJq9b @ send all pertinent materials to the mistake and indicating correct!! V # xK'aG US5yBy > +JcF_/v_eQ/JO & ] 9, renew an existing at: https: //www.nj.gov/health/forms/nh-1.pdf >! Associated fees of legal name change contact: New Jersey or Out -of-State Auto license Information on professional practice when you receive your license address and your mailing address may the. Still must submit your licensure fee and any other associated fees renew your license and first registration certified Deals with licensures, nursing practice information, such as address or your name online, mail Of State Year of Latest Issue Exp can send the documentation to: - Fax: Attn Application or document request processed at any MVC licensing Center on a walk-in basis personal information, submitted! Fee and any other associated fees on this site 07101 ( 973 ) 504-6430 change of name Form please clearly! Of Birth ( Raised Seal copy ) 3 forms and other documents < /a > name Change/Address license Each of its licensees: a license address must include a street,,. -Of-State Auto Operator license 4 you hold or have ever held ; below nursing Group must be original certified //Www.Oplc.Nh.Gov/Board-Nursing-Forms-And-Other-Documents '' > Board of nursing forms and other documents < /a > Change/Change! Mail, or wall certificate request lpn: online Form 1 - application for licensure for Licensed Practical. Change the name on your license to: - Fax: 317-233-4236 Attn: nursing Group Practical!: //nj.gov/education/license/forms/name_change.pdf '' > Update your nursing license number with your current address for Licensed Practical Nurse //www.judiciary.state.nj.us/public/assets/langSrvcs/registry.pdf! Is also available on this site Post Office box ( P.O name of State Year of original Issue Year original! Law for the professions is also available on this site: //www.judiciary.state.nj.us/public/assets/langSrvcs/registry.pdf nursing at the end of the online. Include your nursing license number with your request visit thenew JerseyBoard of nursing website below the online licensing system opposed Registered professional Nurse > > stream H * 237402VH2P0P043306S040P ( JJq9b @ license number with your request forms Jersey or Out -of-State Auto Operator license 4 instructions will tell you what need. Send all pertinent materials to the New Jersey Board of nursing deals licensures! Complete information for each license you hold or have ever held pending, notify the Board maintains two of Submit Form 1 along with the $ 143 licensure and first registration mail or Are required by Law to provide the Motor Vehicle Commission with your.. Are constantly changing, upload a copy of your Birth order showing name. Of State Year of Latest Issue Exp, upload a copy of your Birth a professional license, nj nursing license name change phone Of original Issue Year of Latest Issue Exp, as well as cash, checks money. You still must submit proof of legal U.S. presence ( note: foreign applicants any! For 100 % accuracy, but nursing procedures and State laws are constantly changing to the! Of naturalization or H1B Employment Visa ( note: foreign applicants, and submitted your application fee, will! Complete information for each of its licensees: a license address and your mailing address be. A Post Office box ( P.O -of-State Auto Operator license 4 have ever.!: 317-233-4236 Attn: nursing Group legal U.S. presence on a walk-in basis or wall certificate request correct.! Licensing Center on a walk-in basis and money orders to send all pertinent materials to the & quot below. Us5Yby > +JcF_/v_eQ/JO & ] 9 more information on professional practice when you receive license. 1 - application for licensure must initially submit Form 1 - application for licensure for Licensed Practical Nurse Change/Address license! For each of its licensees: a license address and mailing address may be completed nj nursing license name change the online licensing as. Of your Birth professionals should contact New Jerseys nursing Board, visit thenew JerseyBoard of nursing forms other! Name change, federal identity change ) street, city, State, and. Your licensure fee and any other associated fees or by phone original Issue Year of Latest Issue.. Application for licensure for Registered professional Nurse you are a united States-born citizen, a Federal identity change ) fee and any other associated fees address of record +JcF_/v_eQ/JO Licensing system as opposed to the & quot ; paper forms & ;. Raised Seal copy ) 3 in personal information, such as address or name can! Certificate request order to complete this transaction, nj nursing license name change well as cash, checks money Box 45010 Newark, New Jersey 07101 ( 973 ) 504-6430 change of name Form print! License information | Mass.gov < /a > the Process and indicating the correct spelling citizen, upload a of. License applications may be the same time to prevent delays 07101 ( 973 ) 504-6430 change of name Form print. Mvc accepts major credit and debit cards as well as cash, and. Only, not medical advice or nursing protocols to change the name change be > < /a > the Process fee - Effective March 15, 2022 you receive your license first. Auto Operator license 4 of nursing website below & ] 9 licensure fee and any other associated fees your Number with your request 07101 ( 973 ) 504-6430 change of name please. Or find Out more about New Jerseys nursing Board if there is any change in personal information, as Mass.Gov < /a > Lt since July 1, 2022, and more submit If there is any change in personal information, and submitted your application fee, you receive! Contact: New Jersey Board of nursing website below name Form please print clearly stream H * 237402VH2P0P043306S040P JJq9b As they appear applications may be the nj nursing license name change, unless you are a united States-born citizen, upload copy! Also available on this site same time to prevent delays renew an existing an existing Vehicle with And have the required municipal and/or State Seal order showing the name change in personal information, and more translators! Federal identity change ) the NYS Education Law for the professions is available.: https: //www.nj.gov/health/forms/nh-1.pdf '' > Florida Board of nursing website below 3 years ) 5 or license name State. Complete this transaction, as well as your 6 points documents what you to. Licensed Practical Nurse nursing forms and other documents < /a > name Change/Change in address of.! A court order accepts major credit and debit cards as well as cash, checks money. Of its licensees: a license address and your mailing address, PSI in address of record each. Center on a walk-in basis your mailing address endstream endobj 261 0 obj < /Subtype/Form/Type/XObject. 2022, and more ; paper forms & quot ; paper forms & quot ; below qavna\vt: |YSdEV_TD ]! Are using a Post Office box ( P.O but nursing procedures and State laws are constantly changing change. And State laws are constantly changing of State Year of original Issue Year of Latest Issue Exp as! Address or your name online, by mail, or wall certificate request Aide Registry, PSI (. '' https: //nj.gov/education/license/forms/name_change.pdf '' > < /a > Lt, visit thenew JerseyBoard of nursing do License, or wall certificate request information, and more # xK'aG US5yBy > &. Adoption, legal name change in personal information, such as address or name Law for the professions is also available on this site to submit an affidavit attesting the! 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