Physician Licensure
Attention
Applicant
Pursuant to NRS 630.167, as part of the application
process, you are required to submit to a criminal background investigation. Upon
receipt of your completed application, your License Specialist will send you an
authorization form, the appropriate fingerprint cards, and instructions.
Forms
https://nsbme.us.thentiacloud.net/webs/nsbme/application/#/login
Use this link to apply online for licensure as an Allopathic Physician (MD) in the state of Nevada.
/uploadedFiles/mednvgov/content/Licensees/Application_Checklist_Physician_Application.pdf
/uploadedFiles/mednvgov/content/Licensees/Form_1_Physician_Application.pdf
Medical Education Verification
/uploadedFiles/mednvgov/content/Licensees/Form_2_Physician_Application.pdf
Postgraduate Training Verification
/uploadedFiles/mednvgov/content/Licensees/Form_3_Physician_Application.pdf
Verification of State Licensure
/uploadedFiles/mednvgov/content/Licensees/Form_4_Physician_Application.pdf
Malpractice Claim Verification
/uploadedFiles/mednvgov/content/Licensees/Form_5_Physician_Application.pdf
Hospital / Surgery Center Privileges Verification
/uploadedFiles/mednvgov/content/Licensees/Form_A_Physician_Application.pdf
Release
/uploadedFiles/mednvgov/content/Licensees/Form_B_Physician_Application.pdf
List of Malpractice Insurance Carriers
/uploadedFiles/mednvgov/content/Licensees/Form_C_Physician_Application.pdf
Request for Licensure by Endorsement
/uploadedFiles/mednvgov/content/Licensees/Form_D_Physician_Application.pdf
Request for Licensure by a Resident
/uploadedFiles/mednvgov/content/Licensees/Civil_Applicant_Waiver_Physician_Application.pdf
/uploadedFiles/mednvgov/content/Licensees/Responsibility Statement.pdf
https://nsbme.us.thentiacloud.net/webs/nsbme/application/#/login
Use this link to apply online for licensure as a Special Volunteer Allopathic Physician (MD) in the state of Nevada.
https://nsbme.us.thentiacloud.net/webs/nsbme/application/#/login
Use this link to apply online for licensure as a Special Purpose Allopathic Physician (MD) in the state of Nevada.
/uploadedFiles/mednvgov/content/Licensees/Application_Checklist_Physician_Special_Purpose_Application.pdf
/uploadedFiles/mednvgov/content/Licensees/Form_1_Physician_Special_Purpose_Application.pdf
Medical Education Verification
/uploadedFiles/mednvgov/content/Licensees/Form_2_Physician_Special_Purpose_Application.pdf
Postgraduate Training Verification
/uploadedFiles/mednvgov/content/Licensees/Form_3_Physician_Special_Purpose_Application.pdf
Verification of State Licensure
/uploadedFiles/mednvgov/content/Licensees/Form_4_Physician_Special_Purpose_Application.pdf
Malpractice Claim Verification
/uploadedFiles/mednvgov/content/Licensees/Form_A_Physician_Special_Purpose_Application.pdf
Release
/uploadedFiles/mednvgov/content/Licensees/Form_B_Physician_Special_Purpose_Application.pdf
List of Malpractice Insurance Carriers
/uploadedFiles/mednvgov/content/Licensees/Civil_Applicant_Waiver_Physician_Special_Purpose_Application.pdf
/uploadedFiles/mednvgov/content/Licensees/Responsibility Statement.pdf
https://nsbme.us.thentiacloud.net/webs/nsbme/application/#/login
Use this link to apply online for a Special Event Medical License (MD) in the state of Nevada.
/uploadedFiles/mednvgov/content/Licensees/Form_A_Physician_Special_Event_Application.pdf
Release
/uploadedFiles/mednvgov/content/Licensees/Form_B_Physician_Special_Event_Application.pdf
Hospital / Surgery Center Privileges Verification
/uploadedFiles/mednvgov/content/Licensees/Form_C_Physician_Special_Event_Application.pdf
Verification of State Licensure
/uploadedFiles/mednvgov/content/Licensees/Responsibility Statement.pdf
/uploadedFiles/mednvgov/content/Licensees/Physician Reinstatement to Active or Inactive 2019-2021.pdf
To apply for reinstatement as an Allopathic Physician (MD) in the state of Nevada, download this printable form (pdf), which includes detailed instructions.
/uploadedFiles/mednvgov/content/Licensees/PhysicianStatusChangeToActive2019-2021.pdf
To apply for status change from inactive to active status as an Allopathic Physician (MD) in the state of Nevada (change effective during the 2019-2021 biennium), download this printable form (pdf), which includes detailed instructions.
/uploadedFiles/mednvgov/content/Licensees/Physician Reinstatement to Active Auth Facility Restricted 2019-2021.pdf
To apply for reinstatement
of an Authorized Facility MD license, County-Restricted MD license or Medical
Research Facility-Restricted MD license in the state of Nevada, download this
printable form (pdf), which includes detailed instructions.
/uploadedFiles/mednvgov/content/Licensees/SupervisingPhysicianNotification.pdf
To notify the Nevada State Board of Medical Examiners of supervision of a Physician Assistant, download this printable form (pdf).
/uploadedFiles/mednvgov/content/Licensees/CollaborationPhysicianNotification.pdf
To notify the Nevada State Board of Medical Examiners of collaboration with an Advanced Practice Registered Nurse, download this printable form (pdf).
/uploadedFiles/mednvgov/content/Licensees/TerminationSupervisionCollaborationAgmt.doc.pdf
To notify the Nevada State Board of Medical Examiners of termination of supervision of a physician assistant or collaboration with an Advanced Practice Registered Nurse, download this printable form (pdf).