Nurse Practitioners
Overview of Scope of Practice InformationWhat is Scope of Practice?
Through state laws and regulations, some states limit how a Nurse Practitioner (NP) can interact and deliver care for patients. The limitations are what defines the scope of practice. At Medestar, we understand that keeping up with the changes can be challenging, so we created this page to give an overview of
- Full Practice 100%
These states offer full practice authority to nurse practitioners. Some states may require a collaboration period before full practice authority is granted. The ability to prescribe medication and controlled substances to patients may vary.
Alaska
- Full independent practice authority
- May prescribe prescription drugs and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, national certification, and a consultation and referral plan.
- Nurse Practice Act
Arizona
- Full independent practice authority
- NP may prescribe prescription drugs within his or her population focus (ex: family or adult-gerontology) and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Colorado
- Full independent practice authority
- NP may prescribe prescription drugs and Schedule II-V controlled substances once certain requirements are met including a 3-year mentorship with a physician, listing in the advanced-practice registry, and a written plan for safe prescribing
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Connecticut
- Full independent practice authority after a 3-year physician collaboration period
- NP may prescribe prescription drugs Schedule II and III controlled substances after a 3-year collaboration period
- NPs are recognized in state policy as primary care providers
- Regulatory. Agency: Board of Examiners for Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Delaware
- Full independent practice authority granted after two years of practice under a collaborative agreement with a physician
- May prescribe prescription drugs and Schedules II-V controlled substances; if an NP has not had independent prescriptive authority within the past two years in Delaware or other states must have a collaborative agreement with a physician and complete 30 hours of advanced pharmacology.
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
District of Columbia
- Full independent practice authority
- NP may prescribe prescription drugs and Schedules II-V controlled substances
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, completion of
NP program, and national certification. - Nurse Practice Act
Hawaii
- Full independent practice authority
- NP may prescribe prescription drugs and Schedules II-V controlled substances. Devices may be prescribed if within NP’s specialty
- NPs are recognized in state policy as primary care providers
- Regulatory Agency
: Board of Nursing - Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Idaho
- Full independent practice authority
- NP may prescribe prescription drugs and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers within NP’s specialty
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Iowa
- Full independent practice authority
- NP may prescribe prescription drugs, devices, and controlled substances once they have registered with the DEA and Iowa Board of Pharmacy
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Maine
- Full independent practice authority after 24-months of practice under the supervision of a licensed physician
- NP may prescribe prescription drugs and Schedules II-V controlled substances once registered with the DEA
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduation from NP program, and national certification.
- Nurse Practice Act
Maryland
- Full independent practice authority after 18-months of practice with a physician or another NP who has full practice authority
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduation from NP program, and national certification.
- Nurse Practice Act
Minnesota
- Full independent practice authority after at least 2,080 hours of a collaboration agreement with a physician
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license and national certification.
- Nurse Practice Act
Montana
- Full independent practice authority
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduation from NP program, and national certification.
- Nurse Practice Act
Nebraska
- Full independent practice authority after a transition-to-practice agreement showing 2,000 hours of practice completed under a collaborative agreement
- NP may prescribe independently
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Advanced Practice Registered Nurses
- Licensure Requirements: RN license, graduate degree, and national certification.
- Advanced Practice Registered Nurse Practice Act
Nevada
- Full independent practice authority
- NP may prescribe controlled substances after completing coursework from the State Board of pharmacy
- NPs are recognized in state policy as primary care providers within a specific population focus
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
New Hampshire
- Full independent practice authority
- NP may prescribe prescription drugs and controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
New Mexico
- Full independent practice authority
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
North Dakota
- Full independent practice authority
- NP may prescribe prescription drugs, devices, and controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Oregon
- Full independent practice authority
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Rhode Island
- Full independent practice authority
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances if within NP’s specialty focus
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
South Dakota
- Full independent practice authority after completing 1,040 hours under physician supervision
- NP may prescribe prescription drugs, devices, and Schedules II-V controlled substances
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license and national certification.
- Nurse Practice Act
Vermont
- Full independent practice authority after completing 2,400 hours or 2-years under a collaborative agreement
- NP may prescribe – some restrictions apply
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: Graduate degree and national certification.
- Nurse Practice Act
Washington
- Full independent practice authority
- NP may prescribe prescription drugs and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Nursing Commission
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Wyoming
- Full independent practice authority
- NP may prescribe prescription drugs and Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
- Reduced Practice 50%
These states have laws or regulations that reduce the ability of nurse practitioners to engage in at least one element of NP practice. The prescriptive authority may also be limited.
Alabama
- Reduced practice authority subject to a collaborative agreement with a physician
- May prescribe prescription drugs and Schedules III-V controlled substances provided it is authorized and signed by a collaborating physician
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing and Board of Medical Examiners
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Arkansas
- Reduced practice authority subject to a collaborative agreement with a physician
- May prescribe prescription drugs and Schedules III-V controlled substances if the NP completes a board-approved pharmacology course and has a collaborative agreement with a licensed physician
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Illinois
- Reduced practice authority subject to a collaborative agreement with a supervising physician
- May prescribe prescription drugs and Schedules III-V controlled substances and prescriptive authority must be outlined in the collaborative agreement
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Indiana
- Reduced practice authority subject to a collaborative agreement with a physician
- An NP may prescribe prescription drugs and Schedules II-V controlled substances if outlined in the written collaboration agreement and after certain requirements are met
- NPs are not recognized in state policy as primary care providers
- 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.
- Nurse Practice Act
Kansas
- Reduced practice authority subject to a collaborative agreement with a physician and written medical plan
- A written medical plan of care must be included for each drug an NP can prescribe; NP must register with the DEA and notify the state board of the supervising physician
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Kentucky
- Reduced practice authority subject to a collaborative agreement with a physician
- NP is required to have a collaborative agreement with a physician to prescribe; then after 4 years NP can prescribe independently except for Schedule II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Louisiana
- Reduced practice authority subject to a collaborative agreement with a physician
- May prescribe prescription drugs and Schedules II-V controlled substances but there must be a collaborative practice agreement with a supervising physician
- NPs are recognized in state policy as primary care providers but must choose a population focus
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Mississippi
- Reduced practice authority subject to a collaborative agreement with a physician
- May prescribe prescription drugs and Schedules III-V controlled substances after completing an additional board-mandated educational program
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
New Jersey
- Reduced practice authority subject to a collaborative agreement with a physician
- Collaborative agreement must include a protocol for prescriptive authority; NP must complete a pharmacology course
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduation from NP program, and national certification.
- Nurse Practice Act
New York
- Reduced practice authority subject to a collaborative agreement with a licensed physician
- May prescribe prescription drugs and devices as outlined in collaborative agreement; NP must complete additional pharmacology certificate
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license and graduate degree or national certification.
- Nurse Practice Act
Ohio
- Reduced practice authority subject to a collaborative agreement with a physician
- May prescribe prescription drugs and Schedules III-V controlled substances in collaboration with a physician; NP may prescribe Schedule II controlled substance if the supervising physician initially prescribed it and if the prescription is for a 24-hour period
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Utah
- Reduced practice authority subject to a collaborative agreement with a physician
- A 2-year transition-to-practice period required for Schedule II and III before having independent prescriptive authority; NPs in pain clinics subject to different regulations
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
West Virginia
- Reduced practice authority subject to a collaborative agreement with a physician
3-year transition-to-practice period before authorized to independently prescribe Schedule III-V controlled substances- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Examiners for Registered Professional Nurses
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Wisconsin
- Reduced practice authority subject to a collaborative agreement with a physician
- May prescribe Schedules II-V controlled substances provided as outlined in collaborative agreement
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
- Restricted Practice 5%
These states have the most restrictive laws for the scope of practice for NPs. State law requires supervision or strict protocol in order for the NP to deliver care. Prescriptive authority is also limited.
California
- Restricted practice authority; must have policies in place that follow standards of the state Medical Board
- May prescribe drugs and devices provided it is authorized through the protocols in the collaborative agreement; Schedule II-III require physician involvement and care plan
- NPs are recognized in state policy as primary care providers
- Regulatory Structure: Restricted Practice
- Regulatory Agency: Board of Registered Nursing
- Licensure Requirements: RN license and a graduate degree.
- Nurse Practice Act
Florida
- Restricted practice authority; written protocol required with a physician; general supervision by the physician is required and must be outlined in written protocol
- May prescribe prescription drugs and Schedules II-V controlled substance under the supervision of a physician
- NPs are recognized in state policy as primary care providers
- Regulatory Structure: Restricted Practice
- Regulatory Agency: Board of Nursing and Board of Medicine
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Georgia
- Restricted practice authority; written protocol required with a physician; general supervision by the physician is required and must be outlined in the written protocol
- May prescribe prescription drugs and Schedules II-V controlled substance under the supervision of a physician
- NPs are recognized in state policy as primary care providers
- Regulatory Structure: Restricted Practice
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Massachusetts
- Restricted practice authority; a written collaboration agreement required
- May prescribe prescription drugs as outlined in the written collaboration agreement
- NPs are recognized in state policy as primary care providers
- Regulatory Structure: Restricted Practice
- Regulatory Agency: Board of Registration in Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Michigan
- Restricted practice authority; supervision by a licensed physician is required
- An NP may prescribe nonscheduled drugs without the delegation of a physician. The NP may prescribe Schedules II-V controlled substances if delegated by the supervising physician.
- NPs are not recognized in state policy as primary care providers
- Regulatory Structure: Restricted Practice
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license and national certification.
- Nursing Regulations
Missouri
- Restricted practice authority; written collaborative agreement required
- NP may prescribe as outlined in the collaborative agreement
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduation from NP program, and national certification.
- Nurse Practice Act
North Carolina
- Restricted practice authority; written collaborative agreement required; must be reviewed yearly
- NP may prescribe as outlined in the collaborative agreement
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing and Medical Board
- Licensure Requirements: National certification.
- Nurse Practice Act
Oklahoma
- Restricted practice authority; written collaborative agreement required
- NP may prescribe as outlined in the collaborative agreement
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
South Carolina
- Restricted practice authority;
written protocol with a physician is required - NP may prescribe as outlined in the written protocol; NP may prescribe Schedules II-V controlled substances
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Tennessee
- Restricted practice authority; physician supervision required
- NP may prescribe Schedules II-V controlled substances after receiving a certificate from
state board and only after physician consultation - NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Texas
- Restricted practice authority; written protocol required with a physician
- NP may prescribe as outlined in the written protocol
- NPs are recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
Virginia
- Restricted practice authority; must be in a collaborative agreement for five
year full-time - NP may prescribe as outlined in the written agreement
- NPs are not recognized in state policy as primary care providers
- Regulatory Agency: Board of Nursing and Board of Medicine
- Licensure Requirements: RN license, graduate degree, and national certification.
- Nurse Practice Act
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There’s no better way to understand the right practice setting for you than to test drive your options. After trying locum tenens opportunities in different settings, you may discover that you prefer a hospital-based environment over that private practice you were considering.
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Locum tenens practice offers you the chance to work in diverse clinical settings with various patient populations. Entering a fellowship program? With a temporary position you will advance financially while honing your clinical skills as you begin the next level of training.
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Locum tenens practice offers you the chance to work in diverse clinical settings with various patient populations. Entering a fellowship program? With a temporary position you will advance financially while honing your clinical skills as you begin the next level of training.
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