Nurse Practitioner (AM Shift)

Location: 3065 W. Bancroft St. Unit A, Toledo, OH 43606 Department: Urgent Care & Infusion Center Reports To: Medical Director/Managing Partners Personal Information Full Name * Address * City, State, ZIP * Phone Number * Email * Preferred Contact Method * Phone Email Are you legally authorized to work in the U.S.? * SelectYesNo Are you at least 18 years of age? * SelectYesNo Position Details Position Applying For: * SelectNurse Practitioner NP (AM Shift) Employment Type * Part-Time Full-Time Preferred Shift * Day Evening Weekend Holiday Available Start Date * Are you willing to rotate between Urgent Care and Infusion Center duties? * YesNo Licensure & Certification State of Ohio Nurse Practitioner License Number * License Expiration Date * Board Certification NP-C FNP AGNP Other Prescriptive Authority (CNP - Rx) * SelectYesNo DEA Registration Number DEA Registration Status * Active Pending NPI Number Required Certifications BLS ACLS Preferred Certifications PALS DOT POCUS Are you currently enrolled in or completing continuing education? * SelectYesNo If Yes, Specify: Education Institution * Degree/Program * Year Completed * Graduate Program Accreditation CCNE ACEN COA Other Professional Experience Most Recent Employer Job Title Start Date End Date Supervisor Name/Title Supervisor Contact Information Primary Responsibilities Clinical Setting Urgent Care Emergency Medicine Family Practice Infusion Therapy Other May we contact this employer? SelectYesNo Clinical Skills & Competencies Perform comprehensive H&P exams Diagnose and manage acute illnesses and injuries Prescribe medications and treatments per Ohio law Order and interpret diagnostic tests (labs, X-rays, EKGs) Perform suturing, wound care, I&D, splinting Administer and monitor IV infusions Manage infusion reactions and complications USE EMR systems (e.g. Kareo, DrChrono, AdvancedMD) Familiarity with ICD-10/CPT coding Bilingual communication Additional Professional Experience Professional References Name * Title/Relationship * Phone/Email * Name * Title/Relationship * Phone/Email * Availability & Scheduling Monday Morning Afternoon Evening Tuesday Morning Afternoon Evening Wednesday Morning Afternoon Evening Thursday Morning Afternoon Evening Friday Morning Afternoon Evening Saturday Morning Afternoon Evening Sunday Morning Afternoon Evening Are you willing to work holidays or extended shifts if needed? * SelectYesNo Professional Statement Please describe your motivation for joining Unity Urgent Care & Pharmacy and how your clinical experience aligns with our integrated Urgent Care and Infusion model. Applicant Certification By submitting this application, I certify that the information provided is accurate and complete. I understand that any misrepresentation or omission may result in disqualification or termination if employed. I authorize verification of credentials and references provided. Signature (Typed) * Date * Upload Resume Click or drag a file to this area to upload. Choose File Thank you for your application. It has been sent. There was an error trying to send your application. Please try again later.