2017Wisconsin Act 278, beginning August 1, 2018, prior to submitting an application for a credential, an individual may apply to the Department for a determination of whether the individual would be disqualified from obtaining the credential due to his or her conviction record. To apply for a predetermination, please fill out
Form #3085 and submit all required documentation specified on the form. Pursuant to
Wis. Stat. §
111.335(4)(e), the offenses or kinds of offenses that may result in a refusal, bar, or termination of licensure are published under Additional Resources on the left side of this page.
Pursuant to 2017 Wisconsin Act 319, beginning August 1, 2018, an applicant for an initial credential may apply for a reduction of the initial credential fee that is equal to 10% of the initial fee. Qualification is based on the federal adjusted gross income being at or below 180% of the federal poverty guideline prescribed for the applicant's family household size by the United States Department of Health and Human Services. To determine eligibility please visit the United States Department of Health and Human Services website at https://aspe.hhs.gov/poverty-guidelines, prior to submitting Form 3217.
Wisconsin State Statutes 440.08 (2), the required renewal date for the Advanced Practice Nurse Prescriber credential is 09/30/even years.
Must Provide evidence of holding a current license to practice as a professional nurse in this state or has a current license to practice professional nursing in another state which has adopted the nurse licensure compact.
Please Note: Applicants may apply for the Advanced Practice Nurse Prescriber (APNP) certification and the Registered Nurse (RN) license simultaneously.
Pre-Credential Education Information
Must be certified by a national certifying body approved by the Board as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist.
For applicants who receive national certification as a nurse practitioner, certified nurse-midwife, certified registered nurse anesthetist or clinical nurse specialist after July 1, 1998, the registered nurse must hold a master's or doctoral degree in nursing or a related health field granted by a college or university accredited by a regional accrediting agency approved by the board of education in the state in which the college or university is located. See Form #2923 for Board-Approved Certifying Bodies (Form #2923)
An applicant must complete and submit proof of at least 45 contact hours in clinical pharmacology/therapeutics including title of course, number of pharmacology hours per course and date of completion (a photocopy of the page of a transcript that contains the 3 credit course is acceptable). This must be completed within 5 years preceding the date of application for the certificate.
Application for Licensure
2124||Application for Certification As an Advanced Practice Nurse Prescriber|
|3217||Application for Fee Reduction (This form must accompany the application for the credential)|
2151||Important Application Information for Advanced Practice Nurse Prescriber|
2157||Certification Form for Advanced Practice Nurse Prescriber Who Do Not Carry Personal Liability Insurance Coverage (Complete this form if you do not carry personal liability insurance coverage.)|
2367||Certification of Master's or Doctoral Degree|
2829||Malpractice Suits or Claims Form (if applicable)|
3085||Application for Predetermination (Submit ONLY if you have been convicted of any felony, misdemeanor, or other violations of federal, state, or local law, including municipal ordinances, in this state or any other)|
2252||Convictions and Pending Charges|
3071||Fax Payment Form|