Register Your Facility - Divinity Nursing Agency

Facility Information

Tell us about your facility so we can tailor the right staffing solutions for your needs.

Facility Name *

Please enter your facility name

Facility Type *

Please select a facility type

Address *

Please enter the street address

City *

Please enter the city

State *

Please select a state

ZIP Code *

Please enter ZIP code

Number of Beds (if applicable)

Website (optional)

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Contact Details

Provide the primary contact person details for coordination and staffing requests.

Primary Contact Name *

Please enter primary contact name

Job Title / Role *

Please enter job title

Work Email Address *

Please enter a valid work email

Direct Phone Number *

Please enter phone number

Alternate / Department Phone

Preferred Communication Method

Service Needs

Tell us about the staffing roles, shift coverage, and timelines your facility requires.

Healthcare Professionals Needed *

Registered Nurses (RN) Licensed Practical Nurses (LPN) Certified Nursing Assistants (CNA) Nurse Practitioners (NP) Travel Nurses Allied Health Specialists

Placement & Coverage Type

Per Diem / PRN Shifts Short-Term Contracts (4-13 Wks) Long-Term Placement Emergency / Rapid Coverage

Estimated Shifts per Week

Target Start Timeline

Unit Specifications & Special Requirements

Review & Confirm

Please review your facility information and staffing needs before final submission.

Facility Details

Facility Name

Divinity General Hospital

Facility Type

Hospital

Address

123 Healthcare Way

Location

Tampa, FL 33602

Number of Beds

Not specified

Website

Not specified

Primary Contact

Contact Name

Sarah Jenkins

Job Title

Director of Nursing

Work Email

s.jenkins@facility.com

Phone Number

(402) 881-0573

Staffing Needs

Roles Needed

Registered Nurses (RN)

Placement Types

Per Diem / PRN Shifts

Estimated Shifts

6 - 15 shifts / week

Timeline

Immediately / Urgent

I certify that all information provided is accurate and I am authorized to request staffing on behalf of this healthcare facility.

Please confirm your authorization before submitting

Facility Registration Received!

Thank you for registering your facility with Divinity Nursing Agency. Our dedicated staffing coordinator will review your request and contact your facility within 24 hours.

Reference Code: DNA-842910

Status: Pending Coordinator Review

Support Hotline: (402) 881-0573

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