Profile - C-APN.0000454-C-NP | |
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General Disclaimer: The information posted on the Healthcare Professions Profile Program (HPPP) website was provided by applicants for an original license; applicants for reinstatement or reactivation of an existing license; as well as by those individuals renewing a license. While the Division believes the information to be reliable, human or mechanical error remains a possibility, as does the delay in the posting or updating of information. The Division makes no guarantee as to the accuracy or completeness of the information and the information is not verified by the HPPP staff. The Division will take action to obtain compliance with the requirements to provide accurate and timely information as required by law when information is received that indicates information required by law has not been provided or is not accurate.
Availability Disclaimer:
Malpractice Claims Disclaimer: |
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Name | Rachel Gilmour Patterson |
Credential | C-APN.0000454-C-NP |
HPPP - C-NP Introduction | |||||||||||||
Healthcare Professions Profile |
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Please be aware that this profile is only for your Compact Nurse Practitioner - C-APN license. Do not provide information for other license types you hold on this profile. You will be required to complete a profile for every license you hold that is included in the profiling requirement. All information provided in this profile must be updated within 30 days of any change of information unless your profession's statute says otherwise, or unless the question specifies otherwise. |
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HPPP GLOBAL - Location of Practice | |||||||||||||
Location of Practice |
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1. Are you currently practicing in the healthcare profession associated with this profile? | |||||||||||||
Yes |
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HPPP GLOBAL - Location of Practice If Yes | |||||||||||||
Location of Practice |
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2.
Practice Locations:
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HPPP - NURSING Education and Training | |||||||||||||
Education and Training |
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3.
School or Education Level:
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Masters Degree |
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4.
Please enter the year your initial Degree was achieved: Only enter the year in YYYY format
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2015 |
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HPPP GLOBAL - Other Licenses | |||||||||||||
Other Licenses |
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5.
Have you ever held, or do you currently hold any other licenses in this profession from any other state, country or province?
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Yes |
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HPPP GLOBAL - Other Licenses if Yes | |||||||||||||
Other Licenses |
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6.
Other Licenses:
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HPPP GLOBAL - Board Certifications | |||||||||||||
Board Certifications |
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7.
Do you hold any current Board Certifications?
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Yes |
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HPPP - NURSING Board Certifications if Yes | |||||||||||||
Board Certifications |
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8.
Board Certifications:
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HPPP GLOBAL - Practice Specialties | |||||||||||||
Practice Specialties |
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9.
Do you have a practice specialty in which you are appropriately trained and actively practicing?
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Yes |
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HPPP - NURSING Practice Specialties if yes | |||||||||||||
Practice Specialties |
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10.
Practice Specialties:
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HPPP - RN APN Specialty | |||||||||||||
Advanced Practice Specialties |
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11.
Do you hold an Advanced Practice Authority?
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Yes |
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HPPP - RN APN Specialty if Yes | |||||||||||||
Advanced Practice Specialties |
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12.
Advanced Practice Authority Specialty Area:
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Geriatric Adult |
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HPPP GLOBAL - CO Hospital Affiliations | |||||||||||||
Colorado Hospital Affiliations |
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13. Do you have a current affiliation or clinical privileges with any Colorado Hospital? | |||||||||||||
No |
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HPPP GLOBAL - Other Hospital Affiliations | |||||||||||||
Other Health Care Facilities and Out of State Hospital Affiliations |
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15.
Do you have a current affiliation with any healthcare facility or a non-Colorado hospital?
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Yes |
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HPPP GLOBAL - Other Hospital Affiliations If Yes | |||||||||||||
Other Health Care Facilities and Out of State Hospital Affiliations |
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16.
Other Healthcare Facility Affiliations:
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HPPP GLOBAL - Business Ownership | |||||||||||||
Business Ownership |
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17.
Do you have a current business ownership interest in any healthcare-related business?
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No |
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HPPP GLOBAL - Employer | |||||||||||||
Employer |
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19.
Do you have an employer in the profession in which you are licensed or are applying for a license?
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Yes |
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HPPP GLOBAL - Employer if Yes | |||||||||||||
Employer |
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20.
Employer:
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HPPP GLOBAL - Employment Contracts | |||||||||||||
Employment Contracts |
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21.
Do you have a contract with any business whose mission relates to healthcare services or products where the value is greater than $5000 annually?
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No |
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HPPP GLOBAL - Disciplinary Actions | |||||||||||||
Disciplinary Actions |
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23.
Have you ever had public disciplinary action taken against your license by any board or licensing agency in any state or country?
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No |
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HPPP GLOBAL - Restrictions and Suspensions | |||||||||||||
Restrictions and Suspensions |
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25.
Have you ever entered into any agreement or stipulation to temporarily cease your practice or had a board order issued restricting or suspending your license?
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No |
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HPPP GLOBAL - Healthcare Facility Actions | |||||||||||||
Healthcare Facility Actions |
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27.
Since September 1, 1990, have you had any final actions resulting in involuntary limitations or probationary status on or reduction, nonrenewal, denial, revocation or suspension of medical staff membership or clinical privileges at a hospital or healthcare facility? You are not required to report a precautionary or administrative suspension unless you resigned your medical staff membership or clinical privileges while the suspension was pending.
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No |
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HPPP GLOBAL - Termination of Employment | |||||||||||||
Termination of Employment |
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29.
Have you ever been terminated by an employer for a reason that would be considered a violation of your profession's practice law?
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No |
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HPPP GLOBAL - DEA Registration | |||||||||||||
DEA Registration Surrender |
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31.
Have you ever had to involuntarily surrender your United States Drug Enforcement Agency Administration Registration?
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No |
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HPPP GLOBAL - Convictions | |||||||||||||
Convictions |
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34.
Since you were issued a license to practice your profession in any state or country, have you had any final criminal conviction(s) or plea arrangement(s) resulting from the commission or alleged commission of a felony or crime of moral turpitude in any jurisdiction?
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No |
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HPPP GLOBAL - Malpractice Claims | |||||||||||||
Malpractice Claims |
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36.
Since September 1, 1990, have you had any final judgment, entered into a settlement, or paid an arbitration award for malpractice?
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No |
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HPPP GLOBAL - Malpractice Carrier Refusal | |||||||||||||
Malpractice Carrier Refusal |
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38.
Have you been denied liability insurance, or has your liability insurance coverage been limited, restricted or terminated by the insurance carrier?
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No |
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HPPP GLOBAL - Optional Narrative | |||||||||||||
Optional Narrative |
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40.
Optional Narrative:
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Adult Gerontology Primary Care Nurse Practitioner Certification through American Academy of Nurse Practitioners. |
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HPPP GLOBAL - Attestation | |||||||||||||
Attestation |
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By submitting this Healthcare Professions Profile to the Division of Professions and Occupations you are attesting that:
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41. Submission Date: | |||||||||||||
08/03/2016 |
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Review | |||||||||||||
Please make sure to PRINT THIS SCREEN for your records. To do so, you can click the button in the upper right hand corner of this screen labeled "Print Review". You will not be able to print after you leave this review screen. |
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