Provider Setup

Complete this form for each practitioner

If a practitioner has multiple provider numbers, you only need to complete this form once — simply add the various provider numbers on the form.

If this is for a community nursing provider and you have various community nursing providers, just complete the form once and list all provider numbers in the field provided.

For multiple providers, tell us the suburb for that provider. E.g., Pete Sampras 123456AF (North Sydney)