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CRNA CHECKLIST

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1) Current Curriculum Vitae (Month/Year format)

2) Signed copy of New York State Registered Professional Nurse Registration Certificate

 

3) Copy of Registered Nurse degree

 

4) Bachelor of Science degree

 

5) Nurse Anesthetist Master of Science degree

 

6) Nurse Anesthetist Certification Certificate

 

7) Certificate of Infection Control and Barrier Precautions Course Work

 

8) Copy of current BLS, ACLS, & PALS Certificate, as applicable

 

9) Color copy of 2 valid picture ID’s (drivers license and US passport)

 

10) Current Certificate of Malpractice Insurance

 

11) Confirmation of NPI Number

 

12) Current Recertification Card

 

13) AANA card

 

14) Current Copy of CME’s (Continuing Medical Education credits)

 

15) Current Health Assessment (signed by Physician)

 

16) PPD (Chest X-Ray if positive)

 

17) Titers(must have lab values)

 

18) Influenza vaccine

 

19) Copy of Social Security Card

Please email all documents and the application to l.rodriguez@qualityanesthesiany.com

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