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Username and PIN Code Request

Please complete all required fields () below and click once on the "Submit" button to have your Username and PIN Code sent to the email address on file with Arizona State Board of Nursing. To cancel click on the "Cancel" button.

If you do not know your license number, you may look it up using the online verification form and search by name.

Identification Information





Enter numbers only
 


Click to Verify

Documents & Forms



Agency Fee Structure
Statement of Citizenship or Nationality Form
Name Change Form
Address Change Form