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Are you a Nurse Practitioner Student, a practicing health care provider (MD, DO, APRN, PA, CNM, etc...) or a Medical Practice?*

Student

Health Care Provider

Medical Practice

Name*

First

Last

Company*

Office Phone*

Extension

Email address*

Mobile Phone*

City*

State*

Password*

Password Confirmation*

Gender*

Male

Female

We need your gender because preceptors may require it for certain specialties.

School*

Other School*

Professional Information

Degree*

Please select your medical degree. To precept our students, you MUST be a practicing health care provider.

Which specialties can you precept?*

Acute Care

Adult

Advanced Assessment

Allergy

Cardiology

Dermatology

Education

Elder Care

ENT

ER

Family

Gastroenterology

Hospitalist

Infectious Disease

Internal Medicine

Leadership & Management

Neurology

Oncology

Ophthalmology

Orthopedics

Pain Management

Pediatrics

Plastic Surgery

Psychiatry

Psychiatry - Elder Care

Psychiatry - Pediatric

Psychotherapy

Psychotherapy - Elder Care

Pulmonary

Radiology

Research

Surgery

Urology

Women's Health

Will you accept male students for Women's Health?*

Yes

No

Do you offer telepsych services?

Yes

No

Practice Information

Please enter the following information about the medical practice where you work.

Company Name*

Contact Name*

First

Last

Contact Email*

Contact Phone*

Street Address*

City*

State*

Zip Code*

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Enroll me in a FREE NP Nation Lite membership (optional)

NP Nation is a nationwide advocacy group and membership organization for nurse practitioners. NPN advocates for nurse practitioner rights and participated in campaigning for independent practice. As an NPN member, you'll gain access to discounted malpractice insurance and we'll send you occasional email offers for relevant products and services. There's NO COST for the Lite membership and you may opt-out at any time.

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