Did you take the nursing certification exam?
If you submit your application to Seattle and you're not called for interview then you're good to go
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. No need for US visa. I don't know if you can submit a medical with the initial application. The list of DMPs are in the website anyway. But if you want to make sure you can wait till they send the med request before going to a DMP. The only time you go to the border is when you already have the work visa stamped on your passport (after passport is requested) to pick up your work permit. When you cross to the US border you just inform the CBP officer that you're there to get your work permit and then they will turn you around. Sometimes you don't even have to really cross to the US side, you just do a u-turn

Request for your visit extension as soon as you've sent off your app to Seattle so you're on implied status. Era said that processing was about a month(?) in her case.