How to Fill Out and Submit the Maryland Board of Nursing Name Change Form

To process a Maryland Board of Nursing name change, download the Change of Name Form from the Board’s website, complete it with your former and new legal names, attach one piece of supporting legal documentation, and send the packet to MBON.InfoChange@maryland.gov or to the Board’s Baltimore office. The update turns entirely on matching the names on your form to the names on your legal document, letter for letter.

Pick the Right Legal Document

The Board accepts four types of documentation, and you only need one:

  • A certified marriage certificate or abstract from the vital records office (not the decorative certificate from the ceremony).
  • A divorce decree that includes a name-change clause, with the judge’s signature visible on the copy you submit.
  • A court order authorizing a legal name change.
  • A government-issued identification card or driver’s license already showing your new legal name.

The Board’s renewal page points to the same requirement, citing “appropriate legal documentation (marriage certificate/abstract, a divorce decree/dissolution showing name change clause (with judge’s signature), or a court record indicating a name change)” under COMAR 10.27.01.10D(2)(b).1Maryland Department of Health. Maryland Board of Nursing On-Line License and Certification Renewal The form itself adds the ID or driver’s license option.2Maryland Board of Nursing. Change of Name Form

If you only have the keepsake copy from your wedding, that will not satisfy the Board. You need the certified copy with a raised seal from your county’s vital records office. The same thinking applies to divorce decrees: a partial printout missing the judge’s signature page will be rejected. Make a clean, legible photocopy; blurry or cut-off pages cause delays.

Fill Out the Change of Name Form

Download the current version from the Board’s information page under “Name Change Form.”3Maryland Board of Nursing. Board of Nursing – Information Don’t use an old copy, because the Board updates its forms periodically.

The form has three parts. Part I collects your identifying information: license or certificate number, Social Security number, email, phone, and mailing address. Part II asks for your former name (last, first, middle) and your new legal name (last, first, middle). Part III is a checklist where you mark which supporting document you’re including.2Maryland Board of Nursing. Change of Name Form

Two name-matching rules do most of the work. Your “former name” has to match what the Board currently shows on your license, not a nickname or a prior former name. Your “new name” has to match your legal document exactly, including middle names and suffixes. If your marriage certificate reads “Catherine” but you go by “Katie,” the form needs “Catherine.” Sign and date the bottom. If you fill the form in by hand, print clearly; messy handwriting is a common cause of processing hiccups.

Send It to the Board

You have two submission routes. Email the completed form and documentation to MBON.InfoChange@maryland.gov, or mail the packet to the Board at 4140 Patterson Avenue, Baltimore, Maryland 21215-2254.4Maryland Department of Health. Board of Nursing – Contact Information Email is faster and leaves you a sent-message record. If you mail the packet, use a trackable method so you have proof of delivery.

The current fee schedule under COMAR 10.27.01.02 does not list a specific charge for processing a name change.5Justia. Code of Maryland Regulations 10.27.01.02 – Fees The schedule does include a charge for a duplicate certificate of initial licensure if you want a replacement card showing your new name. The Board updated its fee schedule effective July 2025, so check with the office for the current amount rather than relying on older figures.

Confirm the Change Went Through

The Board does not publish a guaranteed turnaround time for name changes. The way to confirm your record has been updated is the Board’s online license verification tool, which pulls directly from the licensure database and refreshes each business day.6Maryland Board of Nursing. Maryland Board of Nursing License Verification Set the profession to match your license type and search by license number or by name.7Maryland Board of Nursing. Lookup A License Once your new name appears in the lookup, the update is complete and visible to anyone verifying your license, including employers and credentialing offices.

If You Hold a Compact Multistate License

Maryland is a member of the Nurse Licensure Compact.8Maryland Department of Health. Nurse Licensure Compact Your Maryland update feeds the national Nursys database, which draws from state boards and serves as the primary source for nurse licensure data. No separate application is required for the compact side.

If you also hold a single-state license in a non-compact jurisdiction, that board will not pick up the Maryland change. You have to contact it directly to update its own records.

Update Your Name Everywhere Else

Fixing the Board’s record is the first step, not the last. Hospitals and healthcare systems accredited by the Joint Commission are required to perform primary source verification of your license, meaning they check the Board’s database directly rather than trusting a copy of your card.9The Joint Commission. Verification – Primary Source Verification – Definition Once the Board’s lookup shows your new name, tell your employer’s credentialing department so they can re-verify and update their files.

If you are an advanced practice registered nurse with prescriptive authority, your DEA registration needs to carry your current legal name. The DEA’s online registration system handles modifications to existing registrations, and you may need to contact the DEA directly to confirm the right process for a name update. A mismatch between your DEA certificate name and your state license name can create problems at the pharmacy counter.

Your NPI record through CMS, any national specialty certification, and your malpractice policy all need the same update. Work on these in parallel once the Board’s database shows the new name, and point each organization to the verification lookup if they ask for proof.