Application for a Medicare provider number and/or PBS prescriber number for a midwife or nurse practitioner form (HW088)

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.

Download and complete the Application for a Medicare provider number and/or PBS prescriber number for a midwife or nurse practitioner form.

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.

To fill in this form digitally you will need a computer and Adobe Acrobat Reader, or a similar program. You can download Adobe Acrobat Reader for free. If you can’t complete the form digitally, you can print it, complete it by hand and return it to us following the instructions on the form.

If you have a disability or impairment and use assistive technology, you may not be able to access our forms. If you can’t, please contact us. We can help you access, complete and submit them.

Page last updated: 1 April 2022