Physician Assistant

​​​​If you have questions pertaining to information on this page, contact Teresa Kleinhenz (502) 764-2601 or by email .

Application For Licensure

To apply for Physician Assistant Licensure, review all of the following items prior to clicking on the Application link below.

To determine eligibility for Physician Assistant Licensure review these requirements​. You are required to have a Kentucky supervising physician and alternate supervising physician to practice in Kentucky.

  1. Once you click on the application link, you will be required to create a login profile by choosing "Create An Account" on the top of page.
  2. Enter your name exactly as it appears on your social security card. The Department for Medicaid Services requires your name appear in our database exactly as it does on your social security card.
  3. After you have created a login profile, you have initialized your application process which consists of demographic information only.
  4. Upon completion of the login profile, you will be prompted to "Click Here To Apply For License."
  5. After completing the online application, you will be prompted for a $100.00 non-refundable application fee. Payment may be made by credit card or ACH debit.
  6. Once the payment is complete, close the receipt page and your Account/Profile page will open. Download/print the PA Application Addendums. These addendums are required for licensure. NOTE: You have one (1) year from the date you pay your application fee to complete the licensure process.
  7. *Click Here to Begin Application Process

*The above link is for new applicants only. If you have an inactive license, contact the Board at the number above. Please do not create a new account and pay the application fee. This fee is non-refundable.

Supervising Physician Application

If you are a physician assistant currently licensed in the state and are changing jobs, your new supervising physician must complete an application for supervision. Please complete the application and submit the fee to the Board.  Board approval must be granted prior to practicing under a new supervising physician.  Please note the supervising physician application fee is non-refundable.   ​ If at any time a supervising physician ceases to employ or supervise you, you must notify the Board, in writing, within three (3) business days.

Supervising Physician Application

(The Supervising Physician Application contains fillable fields however, original signatures are required. Please print the application and mail to the Board.)

State Committee Members

Timothy K. Thurston, PA-C, Boaz, Chairman
Tamella Cassis, M.D., Prospect
George M. Dimeling IV, M.D., Nicholasville
Sherry Grace, PA-C, Louisville
Tammy R. Jewell, PA-C, Dayton
Stephanie Morgan-White, Esq., Prospect
Marty W. Mullins, PA-C, Hazard
Patrick D. Pepper, PA-C, Lexington
Van Young, M.D., Crestview Hills

Statutes and Regulations

Kentucky Revised Statutes - Chapter 311

Kentucky Administrative Regulations - KARs

Physician Assistant Prescriptive Authority for Controlled Substances 

Application for Prescriptive Authority

Important Information

Meeting and Deadline Dates

Fee Schedule

Definitions of Levels of Supervision

Duplicate Forms

If at any time you need additional and/or duplicate application forms, you will need to log into your profile and access the instructions/forms​​. This is the only way to obtain these forms.