Scope of Practice - Nurse Practitioners

Scope of Practice by State – Nurse Practitioner:

Full Practice: State practice and licensure laws provides for all nurse practitioners to evaluate patients, diagnose, order and interpret diagnostic tests, initiate and manage treatments—including prescribing medications and controlled substances—under the exclusive licensure authority of the state board of nursing. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and National Council of State Boards of Nursing.

Reduced Practice: State practice and licensure laws reduces the ability of nurse practitioners to engage in at least one element of NP practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care or limits the setting of one or more elements of NP practice.

Restricted Practice: State practice and licensure laws restricts the ability of a nurse practitioner to engage in at least one element of NP practice. State law requires career-long supervision, delegation, or team-management by another health provider in order for the NP to provide patient care.
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Alabama
Reduced Practice
Prescriptive Authority: Collaborative Practice under authority of a physician
Regulatory Agency: Board of Nursing and Board of Medical Examiners
Licensure Requirements: RN license, graduate degree, and national certification.

Alaska
Full Practice
Prescriptive Authority: Full Authority with licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, national certification, and a consultation and referral plan.

Arizona
Full Practice
Prescriptive Authority: Full Authority with DEA licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Arkansas
Reduced Practice
Prescriptive Authority: Requires collaborative practice agreement with a supervising physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

California
Restricted Practice
Prescriptive Authority: Requires supervision of a physician or surgeon
Regulatory Agency: Board of Registered Nursing
Licensure Requirements: RN license and a graduate degree.

Colorado
Full Practice
Prescriptive Authority: Full privileges after 1,000 hours with "provisional prescriptive authority"
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Connecticut
Full Practice
Prescriptive Authority: Full authority with licensure after three years of collaborative practice under physician
Regulatory Agency: Board of Examiners for Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Delaware
Reduced Practice
Prescriptive Authority: Requires a collaborative agreement with a physician unless NP has special permission from the Board
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

District of Columbia
Full Practice
Prescriptive Authority: Full authority with licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, completion of NP program, and national certification.

Florida
Restricted Practice
Prescriptive Authority: Requires supervision of a physician or surgeon
Regulatory Agency: Board of Nursing and Board of Medicine
Licensure Requirements: RN license, graduate degree, and national certification.

Georgia
Restricted Practice
Prescriptive Authority: Requires a "protocol agreement" with a supervising physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Hawaii
Full Practice
Prescriptive Authority: Full authority with APRN licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Idaho
Full Practice
Prescriptive Authority: Full authority with APRN licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Illinois
Reduced Practice
Prescriptive Authority: Requires a written collaborative agreement with a supervising physician or other healthcare professional
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Indiana
Reduced Practice
Prescriptive Authority: Requires a collaborative practice agreement with a supervising medical professional
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license and graduate degree or RN license and completion of NP certificate program along with national certification.

Iowa
Full Practice
Prescriptive Authority: Full authority with advanced registered nurse practitioner (ARNP) licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Kansas
Reduced Practice
Prescriptive Authority: Requires a written protocol from a responsible physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Kentucky
Reduced Practice
Prescriptive Authority: Requires a written agreement (CAPA-NS) with a supervising physician or other healthcare provider
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Louisiana
Reduced Practice
Prescriptive Authority: Requires a Collaborative Practice Agreement (CPA) with a physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Maine
Full Practice
Prescriptive Authority: Full authority with APRN licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduation from NP program, and national certification.

Maryland
Full Practice
Prescriptive Authority: Full authority with APRN licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduation from NP program, and national certification.

Massachusetts
Restricted Practice
Prescriptive Authority: Under the authority of a supervising physician
Regulatory Agency: Board of Registration in Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Michigan
Restricted Practice
Prescriptive Authority: Can prescribe nonscheduled drugs, but NPs need physician oversight to prescribe schedule 2-5 drugs
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license and national certification.

Minnesota
Full Practice
Prescriptive Authority: Full authority with APRN registration
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license and national certification.

Mississippi
Reduced Practice
Prescriptive Authority: Under the supervision of a collaborative or consulting physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Missouri
Restricted Practice
Prescriptive Authority: Requires a Collaborative Practice Agreement (CPA) with a supervising physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduation from NP program, and national certification.

Montana
Full Practice
Prescriptive Authority: Full authority with APRN licensure and Prescriptive Authority application
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduation from NP program, and national certification.

Nebraska
Full Practice
Prescriptive Authority: Full authority following Controlled Substance Registration with the DEA
Regulatory Agency: Board of Advanced Practice Registered Nurses
Licensure Requirements: RN license, graduate degree, and national certification.

Nevada
Full Practice
Prescriptive Authority: Full authority with a license from the NV Board of Pharmacy
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

New Hampshire
Full Practice
Prescriptive Authority: Full authority with APRN licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

New Jersey
Reduced Practice
Prescriptive Authority: Requires a "joint protocol" with a collaborating physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduation from NP program, and national certification.

New Mexico
Full Practice
Prescriptive Authority: Full prescriptive authority with DEA registration and state certification
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

New York
Reduced Practice
Prescriptive Authority: Newly certified NPs must have a written collaborative agreement and protocol with a physician and pursue DEA registration
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license and graduate degree or national certification.

North Carolina
Restricted Practice
Prescriptive Authority: Prescriptive authority requires a supervising physician and use of the Controlled Substances Reporting System (CSRS)
Regulatory Agency: Board of Nursing and Medical Board
Licensure Requirements: National certification.

North Dakota
Full Practice
Prescriptive Authority: Full authority with application for prescriptive privileges
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Ohio
Reduced Practice
Prescriptive Authority: A certificate to prescribe requires a "standard care agreement" with a collaborating physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Oklahoma
Restricted Practice
Prescriptive Authority: Requires a written collaborative agreement with a physician licensed by the State Medical Board or Board of Osteopathic Examiners
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Oregon
Full Practice
Prescriptive Authority: Full prescriptive authority with APRN licensure
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Pennsylvania
Reduced Practice
Prescriptive Authority: Requires a collaborative agreement with a physician and DEA registration (for controlled substances)
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Rhode Island
Full Practice
Prescriptive Authority: Full prescriptive authority with Uniform Controlled Substances Act Registration (CSR)
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

South Carolina
Restricted Practice
Prescriptive Authority: Requires an approved written protocol with a collaborating physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

South Dakota
Full Practice
Prescriptive Authority: Requires a collaborative agreement with a physician and DEA registration (for controlled substances)
Regulatory Agency: Board of Nursing and Board of Medical and Osteopathic Examiners
Licensure Requirements: RN license and national certification.

Tennessee
Restricted Practice
Prescriptive Authority: Requires written protocol with a supervising physician
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Texas
Restricted Practice
Prescriptive Authority: Requires a separate application, a written "prescriptive delegation" from a supervising physician, DEA registration for controlled substances, and registration with TX Department of Public Safety
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Utah
Reduced Practice
Prescriptive Authority: Requires a UT Controlled Substances License, DEA registration, and at least two years (or 2,000) hours of post-licensure experience (to prescribe schedule 2 controlled substances)
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Vermont
Full Practice
Prescriptive Authority: Full practice after fulfilling "transition to practice" hours under a collaborative agreement with a physician, DEA registration, and VT Prescription Monitoring System (VPMS) registration
Regulatory Agency: Board of Nursing
Licensure Requirements: Graduate degree and national certification.

Virginia
Restricted Practice
Prescriptive Authority: Requires a "practice agreement" with a collaborating physician
Regulatory Agency: Board of Nursing and Board of Medicine
Licensure Requirements: RN license, graduate degree, and national certification

Washington
Full Practice
Prescriptive Authority: Full authority with prescriptive privileges application
Regulatory Agency: Nursing Commission
Licensure Requirements: RN license, graduate degree, and national certification.

West Virginia
Reduced Practice
Prescriptive Authority: Authority to prescribe after three documented years of experience under a collaborative agreement and with conditions (e.g., schedule III drugs limited to a 30-day supply)
Regulatory Agency: Board of Examiners for Registered Professional Nurses
Licensure Requirements: RN license, graduate degree, and national certification.

Wisconsin
Reduced Practice
Prescriptive Authority: Requires "certification as an advanced practice nurse prescriber" with proof of collaborative physician agreement
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

Wyoming
Full Practice
Prescriptive Authority: Full privileges with prescriptive authority application
Regulatory Agency: Board of Nursing
Licensure Requirements: RN license, graduate degree, and national certification.

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