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 (LARK)
NumberLARK-ENR-DEMO-4045
Issued byLarkspur Health Plan
Valid fromMay 31, 2024
Valid throughMay 31, 2027

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