The Nurse Practitioner (NP) is an Advanced Practice Registered Nurse (APRN) with a graduate-level nursing degree (master’s or doctoral) or post-graduate nursing certificate. This graduate-level education, combined with years of experience in patient care, enables Nurse Practitioners to provide patient care services in a role similar to a Physician.
The Nurse Practitioner practice includes but is not limited to:
- Takes Patient Histories,
- Performs Patient Examinations – Health Assessment and Diagnosis,
- Orders, Conducts and Analyzes Diagnostic and Laboratory Tests,
- Develops, Prescibes, and Coordinates Treatment Plans,
- Makes Referrals to Specialists,
- Manages Acute, Chronic, and Complex Health Problems,
- Advocates for Patients and Families,
- Works as an Inter-Disciplinary Consultant,
- Educates Patients on Healthy Lifestyles and Disease Prevention, and
- Prescribes Medications.
Nurse Practitioners are compassionate caregivers and possess empathic listening skills for patients and their family members. They are problem solvers performing in a Patient-Centered Care model.
Nurse Practitioner vs Physician
While Nurse Practitioners and Physicians perform many of the same patient care tasks listed above, these care providers come from different backgrounds.
Nurse Practitioners
Most applicants to Nurse Practitioner degree programs have completed a four-year Bachelor’s of Science in Nursing ( BSN) degree. Like Physicians, Nurse Practitioner students receive instruction in diagnosing and treating diseases using medications or medical procedures. Unlike Physicians who are not required to have any prior medical experience before Medical School, applicants to Nurse Practitioner degree programs must have a minimum number of years of patient care experience.
Graduates of Nurse Practitioner programs must complete a certification exam in their area of specialization before obtaining a license to practice in their state.
Physicians
Medical students complete a science-oriented Pre-Medical undergraduate major and apply to a Medical School that is usually four years in length. After completing Medical School with its clinical rotations, the graduate must pass the USMLE or COMLEX-USA exam before medical licensure. A licensed Physician interested in a specialized area of practice will pursue a residency program, which may take an additional three to eight years of study.
Nurse Practitioners undertake extensive training and have accumulated many years of prior patient care experience. As a result, they are care providers who positively impact healthcare delivery today and in the future. The deliberate choice hospitals, clinics, and healthcare systems make to hire Nurse Practitioners is due to the shortage of Physicians and the cost-effective way Nurse Practitioners deliver safe and high-quality patient care. The aging of the baby boomer generation, with their more complex patient care needs, amplifies these hiring decisions.
Nurse Practitioners play an expanding role in healthcare delivery, especially in primary care. The Future of Nursing: Leading Change, Advancing Health report from the National Academy of Sciences, Institute of Medicine (IOM) reported that only 2% of medical students and residents were entering primary care. Meanwhile, the number of Nurse Practitioners per primary care Physician more than doubled from 0.23 to 0.48 between 1995 and 2009.
Employment projections support the expanding healthcare delivery role for Nurse Practitioners. The U.S. Bureau of Labor Statistics reported that NP employment will grow by 46% between 2021 and 2031. This employment growth is the fastest of any profession tracked by the BLS.
Patients around the country are learning to rely on a Nurse Practitioner instead of a Primary Care Physician. The Nurse Practitioner’s responsibility is to educate the patient about the quality of care they can expect to receive. Additionally, the NP will indicate how they make referrals to Physicians and specialists. The Nurse Practitioner also helps the patient and their family members recognize that the NP is part of a larger patient care team.
The role of the Nurse Practitioner is one of compassionate, Patient-Centered Care. NPs possess the ability and willingness to build trust with each patient they serve to earn mutual respect and produce outstanding patient outcomes.
Practice Specialties
Two ways Nurse Practitioner practice specialty are determined is by Patient population and area of clinical specialization. The focus of an advanced degree or graduate-level certificate determines an NP‘s practice specialty. This website includes job descriptions for the most widely offered advanced degrees or graduate-level certificates, which include the following specialties:
- Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) – provides acute care for adolescents to older adults with complex acute, critical, and chronic health conditions,
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) – provides primary care for adolescents to older adults,
- Family Nurse Practitioner (FNP) – provides for primary care of patients throughout their entire span of life,
- Neonatal Nurse Practitioner (NNP) – provides care for premature or critically ill newborns in hospital Neonatal Intensive Care Units (NICUs), developmental pediatric clinics and specialty practices,
- Pediatric Acute Care Nurse Practitioner (PACNP) – provides acute care for infants, children, adolescents, and young adults,
- Pediatric Primary Care Nurse Practitioner (PPCNP) – provides for primary care of infants, children, adolescents, and young adults,
- Psychiatric Mental Health Nurse Practitioner (PMHNP) – provides mental health care for children, adolescents, and adults, and
- Women's Health Nurse Practitioner (WHNP) – provides primary care for women throughout their lifespan, including normal obstetrical and gynecological needs, and manages routine care for newborns.
Other less widely offered advanced degree or graduate-level certificate specialties include:
- Adult-Gerontology Nurse Practitioner (AGNP) – includes core elements of acute and primary care instruction,
- Emergency Nurse Practitioner (ENP),
- Family Psychiatric Mental Health (FPMHNP) – includes elements of Family and Psychiatric Mental Health instruction,
- Pediatric Nurse Practitioner (PNP) – includes core elements of acute and primary care instruction, and
- Women’s Health/Gender-Related (WHGRNP) – includes gender-related subspeciality instruction.
Graduate nursing schools generally design their Nurse Practitioner degree and certificate programs to match the certifications required before obtaining an NP license to practice.
This site provides a Nurse Practitioner Search Tool tool to help you locate degrees and certificates offered by more than 710 schools.
Practice Subspecialties
In addition to the specializations mentioned, some NP programs may offer an area of minor concentration in a practice subspecialty, such as:
- Forensic Science,
- Global Nursing and Health Care,
- Health Informatics,
- Integrated Nursing Care of Autism Spectrum Disorder,
- Nursing Administration,
- Oncology,
- Palliative Care,
- Quality Improvement and Safety Processes in Healthcare,
- Transformative Nursing Education, or
- Women’s Health Studies.
For example, a Pediatric Nurse Practitioner student might choose Oncology or Palliative Care as a minor course of study. The availability of these concentrations varies by the graduate nursing program.
Practice Settings
The advanced education obtained by Nurse Practitioners enables them to work in a wide range of roles in diverse settings:
- Patient Care – in hospitals, clinics, private practice offices, community and rural health centers, schools, and college campuses,
- Research – in pharmaceutical and medical device companies, hospitals, and universities,
- Academia – teaching at universities and colleges, and
- Governmental Agencies – in health departments, regulatory bodies, and military service.
The adjacent chart illustrates practice settings for Nurse Practitioners as reported by the U.S. Bureau of Labor Statistics in 2022.
Scope of Practice
Scope of Practice refers to the degree to which Nurse Practitioners may practice independently of oversight by a Physician. The degree of NP practice independence varies state by state and includes:
- Practice Autonomy,
- Prescriptive Authority,
- Physical Therapy Referral Authority,
- Death Certificate Signature Authority,
- Handicap Parking Permit Signature Authority, and
- Workers’ Compensation Claim Signature Authority.
The ability of Nurse Practitioners to practice with little or no Physician involvement distinguishes the NP from the Physician Assistant (PA) restricted to practice only under the direct supervision of a Physician. Nurse Practitioner Prescriptive Authority varies by state and is regulated closely in the case of controlled substances.
Scope of Practice varies by state, depending on state legislative and regulatory rules. Visit the Color Coded Map and Sortable List to view how the Scope of Practice varies by state. For more detailed information, visit the Board of Nursing for the state of interest. Individual employers may impose Scope of Practice rules that are more restrictive than the state permits.
The growing nationwide shortage of internal medicine and primary care Physicians leads to an increasing degree of independent Nurse Practitioner practice autonomy and authority.
Salary
The adjacent chart of estimated wage data from the U.S. Bureau of Labor Statistics (BLS) shows a national Median (Middle) Annual Salary for a Nurse Practitioner at $129,210 in 2024. This salary is at the 50th percentile, increasing from $109,820 in 2019 to $129,210 in 2024. The 2024 salary is twice the national Median Annual Salary of $67,920 for all wage earners and one and a third times that of Registered Nurses at $98,430.
At the extremes, 10% of Nurse Practitioner salaries lie below $97,860 and 10% above $169,950. Salaries vary by location, practice specialty and setting, and employer.
The BLS reported the highest Annual Mean (Average) Salary for 2024 in the practice settings listed in the following table.
Rank
Practice Setting
For additional information, use these four different presentations of Salary and Employment data as reported by the U.S. Bureau of Labor Statistics.
Current Demand and Future Growth
Of all professions in healthcare, the Nurse Practitioner role will likely continue to experience the highest growth. This rate of growth is due to several factors, including:
- Demand for healthcare services by an aging population,
- Poor lifestyle choices, including unhealthy eating and exercise habits, have resulted in increased chronic illnesses such as obesity and cardiovascular disease,
- More people with access to healthcare,
- Growth in outpatient care services for procedures that once required hospital (inpatient) admission, and
- A continuing shortage of Primary Care Physicians, especially in underserved populations.
Additionally, patients have become more accepting of a Nurse Practitioner instead of a Physician.
Education
The ability to practice as a Nurse Practitioner requires a graduate-level nursing education. Here are several degrees or certificate types:
- Master of Science in Nursing (MSN), Master of Science, Nursing Major (MS-NM), or Master of Nursing (MN) – The master’s degree has been the most commonly offered degree type and is the minimum degree required for Nurse Practitioner education. These degree programs are offered widely by public and private graduate schools. The master’s degree in nursing focuses on advanced nursing theory and care practice. Read more...
- Doctor of Nursing Practice (DNP) – In addition to studying advanced nursing theory and care practice, the DNP emphasizes using research results to improve the NP‘s nursing practice. DNP programs also emphasize the application of Evidence-Based Practice to improve the quality of patient care. The National Organization of Nurse Practitioner Faculties is committed to transitioning all entry-level NP programs to the DNP by 2025. Read more...
- Post-Master's or Post-Doctorate Certificates – Eligibility is limited to individuals with a graduate-level or doctoral-level nursing degree. For example, someone holding an MSN as a Clinical Nurse Specialist (CNS) would be eligible to enroll in an Adult-Gerontology Acute Care Nurse Practitioner (AGACNP) certificate program. Read more...
Prospective students should verify that the Nurse Practitioner program they are considering is accredited. Proper accreditation ensures that graduates are eligible to sit for the certification exams required before becoming licensed to practice.
Use the Nurse Practitioner Search Tool to identify programs for this and other degree combinations from our survey of more than 710 schools.
Education Prerequisites
Prerequisites for entry into graduate-level nursing programs vary by school. The more common are summarized as follows:
- RN with a bachelor’s degree in nursing (BSN or BS-N) – has been the traditional prerequisite for a master’s in nursing or DNP degree and the path most commonly followed. Individuals with a bachelor’s degree in nursing who have worked as a Registered Nurse for several years enter these programs with the advantage of their earlier patient care experience,
- Non-NP Master’s degree in nursing (MSN, MS-N, or MN) – some schools offer accelerated study plans for applicants with a degree in related healthcare specialties. For example, a Clinical Nurse Specialist (CNS) may earn a Pediatric Acute Care Nurse Practitioner (PACNP) certificate, and
- NP Master’s degree in nursing (MSN, MS-N, or MN) – a practicing NP may obtain a certificate in an additional area of practice specialization. For example, a Family Nurse Practitioner (FNP) may earn a Pediatric Primary Care Nurse Practitioner (PPCNP) certificate.
If you satisfy any of these prerequisites, use the Nurse Practitioner Search Tool tool to identify NP programs from our survey of more than 710 schools.
If you do not satisfy any of the above prerequisites, you may be eligible to apply to an Accelerated Program. These programs accept applicants without a college education, non-nursing degrees, two-year nursing degrees, or military or civilian medical training.
Accelerated programs offer a Nurse Practitioner master’s in nursing or Doctor of Nursing Practice (DNP) degree program, and some programs award a BSN in the course of study. Use the Accelerated Degree Program Search Tool tool to identify schools offering Accelerated Nurse Practitioner programs from our survey of more than 710 schools.
Two Nurse Practitioner Instruction Components are academic instruction and supervised clinical practicum. Some schools also include instruction in a Simulation Laboratory, providing a valuable learning experience that bridges Academic Instruction and Clinical Practicum.
Accelerated Degree Programs
Accelerated Degree Programs generally cost less and can be completed more quickly than enrolling in consecutive BSN and MSN or doctoral programs. Use the Accelerated Degree Program Search Tool to identify programs for this and other degree combinations from our survey of more than 710 schools.
Dual Programs
Some schools offer Nurse Practitioner study in Dual Degree and Dual Practice Programs. These programs save the student time and expense by eliminating duplicate coursework.
Dual Degree Programs
Some schools offer a Dual Degree Program that awards two degrees in separate but related areas of study. These programs may award a degree in a Nurse Practitioner specialty and an additional degree from another academic department. A partial list of available degree combinations include:
- Master of Science in Nursing (MSN), paired with a:
- Master of Arts (MA) – Leadership,
- Master of Arts Divinity (MDiv),
- Master of Arts in Religion (MAR),
- Master of BioEthics (MAB),
- Master of Business Administration (MBA),
- Master of Public Health (MPH),
- Doctor of Nursing Practice (DNP), or
- Doctor of Philosophy (PhD) - Nursing Science.
- Post-Master’s Certificate (PMC), paired with a:
- – Doctor of Nursing Practice (DNP).
- Doctor of Nursing Practice (DNP), paired with a:
The availability of Dual Degrees offering varies by Nurse Practitioner specialty and school.
Use this Dual Degree Program Search Tool to identify programs for these and other degree combinations from our survey of more than 710 schools.
Dual Practice Programs
Some schools offer Nurse Practitioner study in a Dual Practice Program. These programs award a single degree that combines the NP with an additional clinical practice role. Education in Dual Practice roles enables graduates to work in an expanded range of practice settings and patient populations. This versatility provides the graduate with more career flexibility and growth opportunities.
Here are a few Dual Practice offerings that include a Nurse Practitioner specialization:
- Certified Nurse Midwife (CNM), paired with a:
- Nurse Educator (NE), paired with a:
These are Nurse Practitioner Dual Practice offerings that include a Clinical Nurse Specialist (CNS) specialization:
- Family Nurse Practitioner (FNP) paired with a:
- Adult-Gerontology Clinical Nurse Specialist (AGCNS).
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) paired with a:
- Adult Gerontology-Acute Care Clinical Nurse Specialist (AGACCNS).
- Pediatric Acute Care Nurse Practitioner (PACNP) paired with a:
- Pediatric Acute Care Clinical Nurse Specialist (PACCNS).
Here are Nurse Practitioner Dual Practice offerings that include another Nurse Practitioner specialization:
- Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), paired with a:
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), paired with a:
- Emergency Nurse Practitioner (ENP), paired with a:
- Family Nurse Practitioner (FNP), paired with a:
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP),
- Emergency Nurse Practitioner (ENP),
- Pediatric Nurse Practitioner (PNP), see related Pediatric Acute Care Nurse Practitioner (PACNP) and Pediatric Primary Care Nurse Practitioner (PPCNP),
- Pediatric Acute Care Nurse Practitioner (PACNP),
- Pediatric Primary Care Nurse Practitioner (PPCNP),
- Psychiatric Mental Health Nurse Practitioner (PMHNP), or
- Women's Health Nurse Practitioner (WHNP).
- Pediatric Nurse Practitioner (PNP), see related Pediatric Acute Care Nurse Practitioner (PACNP) and Pediatric Primary Care Nurse Practitioner (PPCNP), paired with a:
- Pediatric Acute Care Nurse Practitioner (PACNP), paired with a:
- Psychiatric Mental Health Nurse Practitioner (PMHNP), paired with a:
- Adult-Gerontology Acute Care Nurse Practitioner (AGACNP), or
- Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP), or
- Family Nurse Practitioner (FNP),
- Pediatric Nurse Practitioner (PNP), see related Pediatric Acute Care Nurse Practitioner (PACNP) and Pediatric Primary Care Nurse Practitioner (PPCNP), or
- Pediatric Primary Care Nurse Practitioner (PPCNP).
- Pediatric Primary Care Nurse Practitioner (PPCNP), paired with a:
- Women's Health Nurse Practitioner (WHNP), paired with a:
Graduates of these programs may apply for national certification exams and become licensed in both practice areas.
Use this Dual Practice Program Search Tool to identify programs for these and other practice combinations from our survey of more than 710 schools.
Tandem Degree Programs
Tandem Degree Programs award two degrees in the course of obtaining a Nurse Practitioner graduate degree. Here are Tandem Degree offerings for Nurse Practitioners:
- Bachelor of Science, Nursing Major (BS-N), followed by a:
- Master of Science, Nursing Major (MS-N).
- Bachelor of Science in Nursing (BSN), followed by a:
- Master of Science in Nursing (MSN), or
- Doctor of Nursing Practice (DNP).
- Master of Science, Nursing Major (MS-N), followed by a:
- Doctor of Nursing Practice (DNP).
- Master of Science in Nursing (MSN), followed by a:
- Doctor of Nursing Practice (DNP).
- Post-Master’s Certificate (PMC), followed by a:
- Doctor of Nursing Practice (DNP).
- Doctor of Nursing Practice (DNP), followed by a:
- Doctor of Philosophy (PhD).
Use this Tandem Degree Program Search Tool to identify Tandem Degree Programs from our survey of more than 710 schools.
Top 10 Degree and Certificate Offerings
This table displays a count of the Top 10 Nurse Practitioner degrees and certificates offered by more than 710 graduate nursing programs. This count includes degrees awarded individually, as the higher degree in a Tandem Degree Program, or as part of Dual Practice and Dual Degree Program offerings.
Top 10 Specialty Degree Offerings
This table displays a count of the Top 10 Nurse Practitioner specialties offered by more than 710 graduate nursing programs.
Academic Instruction Overview
Schools may offer the academic portion of a degree program in different Instruction Formats:
- Campus-based Classroom – This is the traditional and most common form of instruction and includes live lectures, Read more...
- Online – Some of these programs are entirely Internet-based. However, most online programs require one or more campus visits during instruction, Read more...
- Hybrid – This format combines Campus-based Classroom, and Online Instruction Read more..., and
- Executive – These classes are scheduled during evenings and weekends, enabling students to attend after work hours. Read more...
Review the descriptions of Graduate Nursing Instruction Formats to understand their differences, advantages, and disadvantages.
Supervised Clinical Practicum Overview
A Supervised Clinical Practicum, also known as a Preceptor-ship, occurs in a typical patient care setting such as a hospital or clinic. These Supervised Clinical Practicum consists of at least 500 hours of clinical practice in a particular Nurse Practitioner specialty under a preceptor’s supervision. The preceptor is an experienced NP or Physician in the same practice specialty. The preceptor works with the student in a one-to-one teaching role.
During a typical clinical practice teaching episode:
- The student performs a patient assessment,
- The student presents the case to the preceptor with a diagnosis and treatment plan outline,
- Preceptor reviews and validates the patient assessment and plan,
- The student implements the treatment plan with assistance as needed, and
- The preceptor helps the student review the case and reflect on its implications.
During supervised clinical practice, the student should expand their skills and knowledge, improve and refine the effectiveness and efficiency of their practice, and become increasingly independent in managing patient care. These skills include the ability to develop a trusting relationship with their patients and the patient’s families.
The preceptor is responsible for providing constant feedback and support to the student. Additionally, the preceptor shares evaluation data with the student and Nurse Practitioner faculty.
Practicing as a Nurse Practitioner requires two additional steps following selected degree or certificate completion. These steps are certification and licensing.
Certification
Graduates from NP degree or certificate programs are eligible to sit for one or more Nurse Practitioner specialty exams offered by the American Nurses Credentialing Center (ANCC) , a subsidiary of the American Nurses Association (ANA) . Individuals who successfully pass the specialty certification exam are awarded a Certification credential in their area of specialization. These are national certifications specific to each practice specialties and prerequisite for a state license to practice.
Additionally, Nurse Practitioners may sit for optional certification exams in areas related to their area of practice specialization. This site includes an extensive survey of more than 300 certifications in various nursing and related healthcare specialties.
License to Practice
The Board of Nursing for each state issues licenses to practice as a Nurse Practitioner. The NP scope of practice, including Practice Autonomy and Prescriptive Authority, varies by state.
States participating in the APRN Compact and Nurse Licensure Compact have multistate APRN and RN license agreements. These Compacts ease the transfer of NP licenses and the ability to practice among participating states. Participation in these Compacts varies by state. Check with your state’s Board of Nursing for more detailed information.
Professional Associations
Professional associations represent Nurse Practitioners at international, national, regional, state, and local levels. The American Association of Nurse Practitioners (AANP) represents NPs across all practice specialties at the national level. The National Organization of Nurse Practitioner Faculties (NONPF) represents nursing school faculty and preceptors dedicated to advancing the quality of Nurse Practitioner education.
Nurse Practitioners may be interested in other associations that focus on specific areas of healthcare specialization, such as critical care, emergency care, oncology, psychiatry/mental health, or pediatrics. Associations are also formed at the state and local levels, enabling their members to organize with their neighboring peers to address more localized issues. These associations may be chapters of national or international associations or organized independently.
This site includes an extensive survey of more than 1,800 international, national, regional, state, and local nursing and related healthcare professional associations. These associations provide professional development resources and representation in numerous nursing and affiliated healthcare specialties.