Create New Online Profile

Account Information
  • User IDs and passwords must be at least 6 valid characters.
  • Valid characters include letters, numbers, dashes, underscores and periods.
  • Do not include spaces in your User ID or password.
  • User IDs and passwords are case sensitive.
  • The last 4 digits of your SSN and date of birth are required and will be used only for record location.
  • RN License information is required and must be current in order to register with this site.
  • Please enter your RN license number exactly as it appears. If your state board uses dashes, please include these.
  • If you have a combined RN - APRN license, please enter this number.
  • If you are certified with us, your user ID will be linked to your certification information within one business day.
  • If the automated security code does not register your entry properly, select the refresh button before filling in the information.
User ID:
Confirm Password:
Email Address:
Enter the code shown above::
Mailing Address
First Name:
Middle Name:
Last Name:
Previous Name:
Mailing Address:
State or Province: (USA and Canada only)
Zip/Postal Code:
Phone: (nnn-nnn-nnnn xxxx)
FAX: (nnn-nnn-nnnn)
Include me on the mailing list: Yes No 
AANP Membership Number: (Leave blank if you are not an active member)
Date of Birth:
Last four digits of your SSN:
RN License Number:
RN License State:
RN Expiration Date: