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Practitioner:

Advanced Practice Registered Nurses: Nurse Practitioner Practice Authority

Advanced Practice Registered Nurses (APRNs) are licensed nurses with post-graduate education and training in nursing. They provide primary and/or specialty nursing and medical care in ambulatory, acute and long-term care settings. APRNs may practice autonomously and/or in coordination with health care professionals and other individuals. Masters, post-masters or doctoral preparation and national board certification is required for entry-level practice. There are four types of APRNs. These include: nurse practitioners, certified nurse midwives, certified registered nurse anesthetists and clinical nurse specialists. This site currently features policy information for nurse practitioners and certified nurse midwives.

  • Nurse practitioners (NPs) are registered nurses with specialized, advanced education and clinical practice competency to provide health care for diverse populations in a variety of primary care, acute and long-term care settings.
  • Certified nurse midwives (CNMs), also referred to as nurse midwives, specialize in the provision of care during pregnancy, childbirth and the postpartum period; sexual and reproductive health; gynecologic health; and family planning services, including preconception care.

The links to the right lead to maps showing a comparison of all states and territories for the following policy areas:

  1. Nurse practitioner practice authority
  2. Certified nurse midwife practice authority (shown below)
  3. Nurse practitioners identified as primary care providers
  4. Nurse practitioners authority to sign provider orders for life-sustaining treatment (POLST) forms

Choose a tab to explore different options. For more detailed information, please click on a state or territory.

Advanced Practice Registered Nurses:
Nurse Practitioner Practice Authority

Mobile users can use this dropdown of states if the map is too small.

LEGEND

  • Full independent practice and prescriptive authority
  • Full independent practice authority but transition to independent prescribing period
  • Full independent practice authority but physician relationship required for prescriptive authority
  • Transition to independent practice and prescribing period required
  • Physician relationship required

Practice authority can be defined as nurse practitioners’ (NPs) ability to practice with or without physician oversight. Prescriptive authority refers to a nurse practitioner’s authority to prescribe medications. Some states require nurse practitioners to have a relationship with a physician that outlines procedures the nurse practitioner may perform and procedures for consulting with the physician, including outlining the nurse practitioners prescribing ability. In some states, policy specifies whether nurse practitioners must complete a transition to practice period before practicing or prescribing independently. In other states, nurse practitioners have full independent practice and prescriptive authority, meaning they practice independently with no physician oversight.

Policy areas for Advanced Practice Registered Nurses

Certified Nurse Midwife Practice Authority

Nurse Practitioner Practice Authority

Nurse Practitioner Authority to Sign POLST Forms

Nurse Practitioner as a Primary Care Provider


Practitioner Scope of Practice

  • Behavioral Health Providers
  • Advanced Practice Registered Nurses
  • Optometrists
  • Oral Health Providers
  • Pharmacists
  • Physician Assistants

Advanced Practice Registered Nurses Overview

Learn More About Advanced Practice Registered Nurses

For More Information

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Acknowledgement and Disclaimer: This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under UD3OA22893, National Organizations for State and Local Officials. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. government.

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