131 Airline Drive, Suite 301, Metairie, LA 70001          Phone 504-838-5791     FAX 504-838-5279

Name change

It is the responsibility of every lpn with a Louisiana license to notify the board office immediately in the event of a name change. Remember, the name on your license is the name you must use when signing nursing notes, medication administration records, etc. and it must match your personnel records.

Procedure for a name change request

There is no charge for a name change. The request shall be in writing on the form provided on our website. Request for name change. The form must be completed by licensee and mailed to our office and must be accompanied by all of the following:

  1. Original, CERTIFIED legal document* granting the name change (i.e. marriage license, divorce decree, name change order);
  2. A photocopy of your current driver's license;

Once our office receives the request and the name change is completed, your online account will reflect the change when you login. The name change will also be reflected in Nursys quick confirm.

Please note that the certified document will not be returned. You can call the Clerk of Court office in the parish/county where your paperwork was filed for a certified copy to enclose with your request to our office.

Note:  To view the form, you will need a pdf reader.
  Click the icon or visit www.adobe.com if you do not have a pdf reader.

Other Nursing Sites
Louisiana State Board of Nursing
CNA Certification and Training