NJ CDS Change of Public Address of Record


I am new AGACNP attempting to renew my CDS registration online. However, I am unable to change the Public address of record. The text boxes were grey when I arrived to the screen. The hospital that I am to be employed with is requesting me to have the same practice address for both my CDS and DEA. The practice address is different than my mailing address which is currently in the grey text boxes I mentioned.

When I initially submitted my CDS I was newly graduated and seeking a job. Now having found one I need to change the address to my Practice's. Any help would be greatly appreciated. I'm thinking someone else may have had to go through this. I have called the help lines and have received ZERO help.