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Add Provider to Existing Contracted Groupware:PRACTICE NAME:TAX ID:GROUP NPI: ___
CREDENTIALING CONTACT / ADDRESS:
CONTACT / TITLE
ADDRESS
StreetCityPHONEFAXSTZipEMAILINFORMATION ABOUT PROVIDER BEING
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How to fill out credentialing contact address
How to fill out credentialing contact address
01
Obtain the credentialing application form from the organization or agency that requires the information.
02
Locate the section on the form that requests the contact address for credentialing purposes.
03
Fill out the address fields with accurate and up-to-date information, including street address, city, state, and zip code.
04
Double-check the contact address for any errors or missing details before submitting the form.
Who needs credentialing contact address?
01
Healthcare professionals such as doctors, nurses, and therapists who are seeking to be credentialed by hospitals, insurance companies, or other healthcare organizations.
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What is credentialing contact address?
The credentialing contact address is the official address used for communications related to the credentialing process of healthcare providers or organizations.
Who is required to file credentialing contact address?
Healthcare providers, such as doctors, nurses, and institutions, are typically required to file their credentialing contact address as part of the credentialing process.
How to fill out credentialing contact address?
To fill out the credentialing contact address, provide the full address including street name and number, city, state, and zip code. Ensure all information is accurate and up-to-date.
What is the purpose of credentialing contact address?
The purpose of the credentialing contact address is to provide a reliable point of contact for verification and communication regarding the credentialing status of providers or organizations.
What information must be reported on credentialing contact address?
The information that must be reported includes the physical address, mailing address (if different), and contact information including phone number and email address.
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