NHIN,APPLICATION PROXY (24) NEW PERSON (200)
Name
Value
NAME
NHIN,APPLICATION PROXY
SIGNATURE BLOCK PRINTED NAME
APPLICATION PROXY NHIN
SECONDARY MENU OPTIONS
TIMESTAMP
2025-09-22 17:12:55
DATE ENTERED
2025-09-22 00:00:00
CREATOR
PATCH,USER
USER CLASS
User Class:
APPLICATION PROXY
ISPRIMARY: Yes
