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4 Administrative Policies Pertaining to Advanced Registered Nurse Practitioners II. Parties to Protocol: (Should only list one ARNP & one authorized supervising physician here) A. (Name), ARNP, RN 9999999 ARNP Address 123 Street Anywhere, FL 12345 B. (Name of authorized supervising physician) title, Florida license number, DEA 999999 Physician Address 456 Avenue Anywhere, FL 12345 C. Practice Name Practice Location 123 Main Street Somewhere, FL 99999 III. Nature of Practice: This collaborative.

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