Employee ENPC Provider Registration Form  

 

 

Are you an NCBH, School of Medicine, Wilkes Regional,
Cornerstone, Community Physicians Employee, or Travel Nurse?
 

 
Date to Attend  
Last Name  
First Name  
Middle Initial  
Employee ID  
Credentials (MD, RN, etc)  
Phone Number  
Department Name  
Department Number  
E-mail Address  
Comments/Concerns    
   
We will notify you of your acceptance into the class through the email address you provided in this registration form.  

 

 

Quick Reference

Life Support Education
Mikell White

Phone 336-716-2800
Fax 336-716-5927

Contact Mikell
miwhite@wakehealth.edu

Rebecca Gregory

Phone 336-716-2888
Fax 336-716-5927

Contact Rebecca
rbgregor@wakehealth.edu

 

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Disclaimer: The information on this website is for general informational purposes only and SHOULD NOT be relied upon as a substitute for sound professional medical advice, evaluation or care from your physician or other qualified health care provider.

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