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You may sign-up online below. When you are finished, your membership application will be reviewed by NPI staff. Once your membership has been activated, and your dues have been paid, you'll have full access to all the features of the NPI website. With an inactive account, you can still edit your member details and pay your member dues.

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Email *
Desired Password *	Must be at least 8 characters. Case-sensitive.
Desired Password * (enter again to verify)
First Name *
Middle Name
Last Name *
Post-Nominal Initials	Example: OB/GYN, FNP
Gender	Female Male
Primary Phone *
Primary Phone Type *
Show Primary Phone on Site	Yes No
Secondary Phone
Secondary Phone Type
Show Secondary Phone on Site	Yes No
Alternate Phone
Alternate Phone Type
Show Alternate Phone on Site	Yes No
Fax
Show Fax on Site	Yes No
Address *
City *
State *
ZIP *
Region *	Hold Control on your keyboard to selected multiple regions.
Show Address on Site	Yes No
Work/Provider Name
Work Address
Work City
Work State
Work ZIP
Show Work Address on Site	Yes No
What is the best way to contact you?
Are you actively practicing as an NP?	Yes No
If not, when was the last year you practiced?
NP Specialty *
Do you serve as a preceptor?
Do you do locum tenens?	Yes No
Highest-Earned Degree *	Students may leave this blank.
Name of School
School City
School State
Year of NP Program Completion	If you are currently a student, enter an estimated completion year.
NP Program Specialty
NP Certification Organization	AANP NCC ANCC ONCC PNCB
Other
States of Licensure (list all)
NP License Number * Required for professional members.
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