21 NCAC 33 .0103 eligibility and APPLICATION

(a) Applications for approval to practice as a CNM in accordance with G.S. 90-178.5 are posted on the Board of Nursing's website at www.ncbon.com. The application shall contain the following:

(1) the applicant's name, telephone number and email address;

(2) the applicant's primary address of residence;

(3) the educational degrees obtained by the applicant with the program name and completion date;

(4) the number and expiration date of the applicant's national certification from the AMCB;

(5) other professional or occupational licenses with the license number and jurisdiction in which the license was issued, if applicable;

(6) the name, license number, telephone number, email address, and practice location of the collaborating provider, if applicable;

(7) the full address of the practice location where the applicant intends to practice midwifery; and

(8) the approval to practice number shall be provided on the application if the application is for the renewal or reinstatement of an existing approval to practice.

(b) To be eligible for an approval for independent practice without a collaborating provider as a CNM, an applicant shall:

(1) submit a completed application for approval to practice, attesting under oath or affirmation that the information on the application is true and complete, and authorizing the release to the Committee of all information pertaining to the application;

(2) submit the approval to practice application fee as established in G.S. 90-178.4(b)(1) and Rule .0102 of this Section;

(3) have an unencumbered registered nurse ("RN") license or privilege to practice in all jurisdictions in which a license is or has ever been held;

(4) hold an active, unencumbered North Carolina RN license or privilege to practice;

(5) hold an unencumbered CNM license or an approval to practice in all jurisdictions in which a license or an approval to practice is or has ever been held;

(6) provide an official copy of the educational transcript and certification from AMCB;

(7) attest by oath or affirmation to completion of at least 24 months experience and 4,000 practice hours as a CNM. Documentation of successful completion of this requirement shall be provided to the Committee upon request; and

(8) have no pending court conditions as a result of any misdemeanor or felony conviction(s). Applicant shall provide a written explanation and any investigative report or court documents evidencing the circumstances of the crime(s) if requested by the Committee. The Committee shall use these documents when determining if an approval to practice should be denied pursuant to G.S. 90-178.6.

(c) An applicant seeking approval to practice as a CNM with less than 24 months experience and 4,000 hours of practice as a CNM is required to practice in collaboration with a collaborating provider pursuant to G.S. 90-178.3(b1) and shall:

(1) submit an application for an approval to practice, attesting under oath or affirmation that the information on the application is true and complete, and authorizing the release to the Committee of all information pertaining to the application.

(2) submit the approval to practice application fee as established in G.S. 90-178.4(b) and Rule .0102 of this Section;

(3) hold an unencumbered license or privilege to practice in all jurisdictions in which a license is or has ever been held;

(4) hold an active, unencumbered North Carolina RN license or privilege to practice;

(5) hold an unencumbered CNM license or an approval to practice in all jurisdictions in which a license or an approval to practice is or has ever been held;

(6) provide an official copy of the education transcript and certificate from AMCB;

(7) submit the name and licensure number of the collaborating provider with whom the applicant will collaborate;

(d) Once a CNM has attained 24 months experience and 4,000 hours of practice as a CNM, the CNM shall apply for independent practice by submitting an application attesting under oath or affirmation that the information on the application is true and complete, and authorizing the release to the Committee of all information pertaining to the application and required fee.

(e) Educational transcripts shall be submitted directly to the Committee from the educational institution, National Student Clearinghouse or Parchment. National certification for CNMs shall be submitted directly to the Committee from AMCB.

(f) An applicant shall be required to appear in person for an interview with the Committee if there is a discrepancy in the information submitted.

History Note: Authority G.S. 90‑178.4(b); 90‑178.5;

Eff. February 1, 1984;

Amended Eff. March 1, 2017; January 1, 1989;

Readopted Eff. November 1, 2018;

Amended Eff. April 1, 2020;

Temporary Amendment Eff. October 2023;

Temporary Amendment Exp. July 12, 2024;

Amended Eff. October 1, 2024.