SAMPLE for the demonstration: a fictional certificate, not a real document. In real use this is the scan or PDF the coordinator attaches.

Payer enrollment

Ridgeline Health Partners credential file

Issued toNadia Brooks, APRN, FNP
CredentialPayer enrollment (MCR)
NumberMCR-ENR-DEMO-4043
Issued byMedicare
Valid fromDec 9, 2022
Valid throughDec 9, 2027

Fictional provider and number. Close this tab to return to the Credential Tracker.