Request Name or Address Change
Completion will change your name or address in the North Carolina Board of Nursing records.
In accordance with the Nurse Licensure Compact, change of address may affect the practice privilege for your North Carolina nursing license.
Request Name Change or Address Change
How to submit...
- Access the Nurse Gateway to Request a Name Change or an Address Change
- Select 'Request Name Change' or 'Request Address Change' in the My Profile dropdown
- Complete application
Submit legal documentation* supporting your name change to the North Carolina Board of Nursing.
*Examples of supporting legal documentation include:
- Social Security Card
- Court Record
- Birth Certificate
- Marriage License
- Driver's License
- Voter Registration
- Federal Income Tax Return
Do not submit the original document
Mail, email, or fax your supporting documentation to:
North Carolina Board of Nursing
P.O. Box 2129
Raleigh NC 27602-2129
: (919) 781-9461
Attn. Customer Service
Allow 5-10 business days from the date you submitted your request for processing.