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Entity Registration (Renewal & Update)
National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners: 45 CFR Part 60 Regulations and Forms
OMB: 0915-0126
IC ID: 206504
OMB.report
HHS/HSA
OMB 0915-0126
ICR 202310-0915-003
IC 206504
( )
Documents and Forms
Document Name
Document Type
Form 25
Entity Registration (Renewal & Update)
Form and Instruction
25 Entity Registration (Renewal & Update).pdf
Entity Registration (Renewal Update).pdf
Form and Instruction
Information Collection (IC) Details
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