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2024 CCNPPA Membership Application
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Last Name:
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First Name:
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Email:
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Phone Number
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Advanced Practice
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Nurse Practitioner
Physician Assistant
Clinical Nurse Specialist
Student Nurse Practitioner
Student Physician Assistant
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Current Practice Specialty
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Membership Dues
General Membership (due in February) - $50.00
Half-annual (members joining after August 1st) - $25.00
NP/PA students - $25.00
Associate Membership (non-NP or PA) - $65.00
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