Credentialing Payment

Payment Categories

Active Physician

Consulting Physician

Telemedicine

Allied Health Professional I (PA, ANP, RN, LPN, CRNA, CCP, ORT, ST, RDA, SW, MA, COA, COT)

Allied Health Professional II (Psychologist or Podiatrist)

Late Fee

IMPORTANT

Refunds will not be granted once your application has been submitted electronically.

If you have questions concerning your application, please call Centralized Credentialing at 501-202-4334.

$
USD

e.g. XXX-XXX-XXXX