Louisiana standardized credentialing application 2025

1. Click ‘Get Form’ to open the Louisiana Standardized Credentialing Application in the editor.
2. Begin by filling out the 'General Information' section. Enter your last name, first name, middle name, and suffix. Ensure you select your degree and gender accurately.
3. Complete the contact details including home address, phone number, email, and social security number. Remember to provide any other names you have been known by.
4. Proceed to the 'Primary Practice Location' section. Fill in the institution or clinic name, office manager details, and practice type (solo or group).
5. Continue through each practice location if applicable. For each location, provide similar information as required in step 4.
6. Fill out sections regarding medical records preferences, specialty information, hospital affiliations, education history, work history, professional licenses, references, and insurance coverage.
7. Review all sections for completeness. Attach any required documents as specified in the instructions before submitting your application.

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