From: Denise.Martinez@superiorhealthplan.com  Sub: 1st Request: Credentialing Request; Brittney Brown, FNP_NPI 1275163537  Hello,           Credentialing Request; Brittney Brown, FNP_NPI 1275163537  We received a credentialing application for however, we did not receive all of the documentation necessary to complete the credentialing process.  Please submit the information marked below:                      Page 11 Disclosure Statement Form – complete top, answer Question #2                      Page 12 Disclosure Statement Form – needs signature/date                      Signed and dated attestations pages                      Copy of your Current CLIA                      Certificate of Insurance for Normandy Urgent Care Center PA – certificate must list provider’s name or roster     Please fax or email the requested information to the contact information listed below within 3 days.        Thank you,  Denise Martinez  Credentialing Specialist     cid:image001.jpg@01D541FF.1E22F110  5900 E. Ben White Blvd.  Austin, TX 78741  Toll-Free: 1-800-218-7453  Fax: 1-866-702-4831  Denise.Martinez@superiorhealthplan.com