Application for a Medicare provider number or PBS prescriber number for a midwife or nurse practitioner form (2960)

Use this form to apply for an initial or additional Medicare Australia provider number or PBS prescriber number if you are an eligible midwife or nurse practitioner.

You must be an eligible midwife or nurse practitioner under Section 84AAF/84AAJ of the National Health Act 1953 to apply for a PBS prescriber number.

If you have a disability or impairment and use assistive technology, there are other ways you can do your business with us. You can use self service or request someone to deal with us on your behalf. If you can’t access our forms, please contact us. We can help you access, complete and submit them.

Page last updated: 9 July 2019

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