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Form FA-31C Provider Initial Enrollment Application (Individuals) - Nevada
What Is Form FA-31C?
This is a legal form that was released by the Nevada Department of Health and Human Services - a government authority operating within Nevada. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form FA-31C?
A: Form FA-31C is the Provider Initial Enrollment Application (Individuals) specifically for Nevada.
Q: Who can use Form FA-31C?
A: This form is for individual providers applying for initial enrollment in Nevada.
Q: What is the purpose of Form FA-31C?
A: The purpose of Form FA-31C is to apply for initial enrollment as a provider in Nevada.
Q: What information is required on Form FA-31C?
A: Form FA-31C requires personal and contact information, as well as information about your qualifications and experience as a provider.
Q: Are there any fees associated with submitting Form FA-31C?
A: No, there are no fees required to submit Form FA-31C.
Q: What should I do after completing Form FA-31C?
A: After completing Form FA-31C, you should submit it to the Nevada Medicaid office for review and processing.
Form Details:
- Released on February 18, 2018;
- The latest edition provided by the Nevada Department of Health and Human Services;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form FA-31C by clicking the link below or browse more documents and templates provided by the Nevada Department of Health and Human Services.
Download Form FA-31C Provider Initial Enrollment Application (Individuals) - Nevada
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