Verification Report

Primary Source Board of Nursing Report Summary for

PHOENIX GRAY VELASQUEZ

Saturday, December 07 2019 11:53:29 PM

At this time, the Board no longer posts Complaint - Outcome Pending or any other notification or status under a
regulated party's profile when a possible disciplinary matter has been referred for formal hearing. The notice and
record of the matter heard by the Board remains available in Board meeting agendas and minutes posted on the
Board Meetings page of the Board's website. A search of the Board's meeting minutes can be done by entering the
name of the individual in the search box of the Board's website.

Effective December 31, 2017, Senate Bill 1452 amended A.R.S. §32-3214 with regard to information posted
on the website of a healthcare regulatory board. According to statute, dismissed complaint information is available
to the Board and to the public but may not appear on the Board's website; disciplinary actions and final non-
disciplinary actions, excluding letters of concern and advisory letters, shall be made available on theBoard's
website.

If you wish to obtain additional public records related to any licensee or certificate holder, including dismissed
complaints and non-disciplinary actions and orders, please contact the Board directly at PIR@AZBN.gov
This online verification system is a free service provided to the public for primary source verification of
licensure/certification status for all nursing assistant and medication assistant certificates and licenses issued by
the Arizona State Board of Nursing.

For nursing assistants and medication assistants (credentials beginning with CNA, LNA, UCNA, or CMA), this report
may be used as primary verification when applying for nurse aide or nursing assistant certification in other states.

For primary source verification of nurses (RNs, LPNs, and APRNs), please visit the NURSYS QuickConfirm License
Verification.

The information contained within this verification is the same information provided through other means, i.e.
telephone, facsimile, email or mail, and is true and complete to the best of the Board's knowledge. In addition to
verifying licensure and certification through the online verification system, employers are encouraged to request
picture identification such as a driver's license, passport, or Social Security card in order to verify the individual's
identity.

+++ IMPORTANT: SEARCH BY NAME, NOT NUMBER, FOR NURSING ASSISTANTS +++
Due to recent changes in state law, nursing assistant certification and licensing numbers have changed. For
accurate results, search for nursing assistants by name rather than credential number. This way, all credential
types held with the Board will be visible. If you wish to search by license/certificate number and the number you
are using does not display results, you may need to try searching the different credential types and conduct your
search using UCNA, CNA, and LNA preceding the numerical digits.

Click here for more information regarding the difference between UCNA, CNA, and LNA.
Temporary and Permanent Licenses/Certificates

License/Cer License/Cer Current

Name on License Original Compact
tificate tificate Expiration Discipline
License Status Issue Date Status
Type Number Date
VELASQUEZ,
UCNA100004
PHOENIX UCNA Expired 08/21/2015 04/30/2017 N/A NO
7742
GRAY

License type information

  RN: Registered Nurse
 PN: Practical Nurse (aka Licensed Practical Nurse (LPN), Vocational Nurse (VN), Licensed Vocational Nurse
(LVN))
 CNP: Certified Nurse Practitioner
 CNS: Clinical Nurse Specialist
 CNM: Certified Nurse Midwife
 CRNA: Certified Registered Nurse Anesthetist

Nurse Licensure Compact (NLC) information

 Multistate licensure privilege: Authority to practice as a licensed nurse in a remote state under the
current license issued by the individual's home state provided both states are party to the Nurse Licensure
Compact and the privilege is not otherwise restricted.
 Single state license: A license issued by a state board of nursing that authorizes practice only in the
state of issuance.
 More information about the Nurse Licensure Compact (NLC)