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Independent Provider Registration

Create your account and profile. Your account will be active immediately.

Account

Your NIEMR login details.

Licensing

Your professional registration details.

Profile & Business Information

Your professional identity and bio.

Your business name will be displayed when outsourcing services. If not provided, your personal name will be used.

Contact & Address

How we can reach you and where you practice.

Specialties

Select one or more specialties. You can also add extra ones.

Click to select. Click again to remove. You can pick more than one.

Documents

Upload credentials (PDF/JPG/PNG). Add multiple as needed.

Your information is encrypted and reviewed for verification.
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