Nurse Practitioner
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Back-up Supervising Physician

No specific form is required to list or add back-up supervising Physicians. An on-going list of back-up supervising Physicians approved by your primary supervising Physician, signed and dated by each back-up supervising Physician, the primary supervising Physician, and the Nurse Practitioner, must be retained as described in 21 NCAC 36 .0801 (2) and Rule 21 NCAC 32M .0101 (2) . Do not send the documents to the Boards, but retain those documents for five (5) years.

Last Changed 14-Aug-2018

North Carolina Board of Nursing

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North Carolina Board of Nursing