Medically reviewed by Chaunie Brusie, RN, BSN on September 20, 2021
A Nurse Practitioner (NP) is an Advanced Practice Registered Nurse (APRN) that has earned either a Master's of Science in Nursing (MSN) or a Doctor of Nursing Practice (DNP). They can serve as either a primary or specialty care provider.
Nurse Practitioners earn a higher salary, have more responsibility and more career opportunities than many other types of nurses. This guide will cover what a nurse practitioner does, how much they make, how to become one, and more.
Part One What is a Nurse Practitioner (NP)?
Nurse Practitioners have more authority than Registered Nurses and have similar responsibilities to that of a doctor.
Nurse Practitioners can serve as a primary care or specialty care providers and typically focus their care on a specific population such as families, children, or the elderly. As clinicians, they focus on health promotion and disease prevention in their patients.
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Part Two What Do Nurse Practitioners Do?
NPs are health care providers that can prescribe medication, examine patients, order diagnostic tests, diagnose illnesses, and provide treatment, much like physicians do.
Their experience as working nurses gives them a unique approach to patient care, while their advanced studies qualify them to take on additional duties that are usually left to physicians.
In fact, as reported by the Kaiser Family Foundation (KFF), it’s estimated that NPs can provide 80-90 percent of the care that primary care physicians offer.
Nurse Practitioner Scope of Practice
Nurse practitioners have full practice authority in 25 states, meaning that they do not have to work under the supervision of a doctor.
In the remaining states, NPs still have more authority than RNs, but they need a medical doctor to sign off on certain patient care decisions.
Nurse Practitioner Scope of Practice by State
Part Three Nurse Practitioner Specialties
In addition to being a general nurse practitioner, NPs can also specialize in a specific population. They will often attend a nursing program that allows them to specialize in this area and obtain clinical competency. If they choose a specialization, they'll also need to become certified in the specific specialty area.
- Family Nurse Practitioner
- Acute Care Nurse Practitioner
- Aesthetic Nurse Practitioner
- Pediatric Nurse Practitioner
- Emergency Nurse Practitioner
- Adult-Gerontology Nurse Practitioner
- Psychiatric Nurse Practitioner
- Neonatal Nurse Practitioner
- Women's Health Nurse Practitioner
- Orthopedic Nurse Practitioner
- Oncology Nurse Practitioner
Family Nurse Practitioner
Family nurse practitioners or Family Practice Nurse Practitioners (FNPs) provide primary health care services for individuals and families throughout the lifespan. They often act as a primary care provider for their patients and this can be especially rewarding for those who enjoy developing long-term relationships and getting to know people over time.
Acute Care Nurse Practitioner
Acute Care Nurse Practitioners (ACNPs) are advanced practice registered nurses that provide care to patients in acute care and/or hospital settings. Acute Care NPs see patients when they are sick, admitted to the hospital, or after a surgical procedure and/or trauma. Their focus is solely on caring for the adult population with complex diseases.
Pediatric Nurse Practitioner
Pediatric Nurse Practitioners are Advanced Practice Registered Nurses whose sole focus lies in treating children from infancy through the time they become adults. They see patients on a one-on-one basis, offering care ranging from well check-ups and immunizations to diagnosing illnesses and treating chronic and acute conditions.
Emergency Nurse Practitioner
Emergency Nurse Practitioners assess, diagnose and manage injuries and illnesses that need urgent care. They are able to work with or without supervision, determining which patients need the most immediate care, making decisions about treatment, monitoring patient conditions and providing education and consultation.
Adult-Gerontology Nurse Practitioner
Adult-Gerontology Nurse Practitioners specialize in the care of adults from adolescence all the way up to geriatric care. They work with patients and their caregivers on managing chronic conditions, diseases, and other health conditions.
Psychiatric Nurse Practitioner
Psychiatric Nurse Practitioners or Psychiatric Mental Health Nurse Practitioners (PMHNPs) specialize in the mental health needs of adults, children, families, groups, and/or communities. They help individuals cope with different psychiatric disorders and illnesses and can also help people with substance abuse disorders.
Neonatal Nurse Practitioner
Neonatal Nurse Practitioners care for premature and sick newborns including diagnosing them, providing treatment plans, and prescribing medication. They can also can assist in delivering patients in certain settings.
Women's Health Nurse Practitioner
A Women’s Health Nurse Practitioner (WHNP) specializes in the comprehensive care of women throughout their lives. They focus on reproductive, obstetric, and gynecological health and usually work in a primary care office setting, rather than a hospital or delivery room.
Orthopedic Nurse Practitioner
An Orthopedic Nurse Practitioner focuses on the care and treatment of patients suffering from musculoskeletal problems. These can include disease and/or injuries of the bones, muscles, joints, and supporting connective tissue.
Aesthetic Nurse Practitioner
Aesthetic Nurse Practitioners specialize in cosmetic medical procedures that improve their patients’ appearance. They examine and evaluate patients, counsel them on a variety of procedures, perform those procedures, and care for them as they recover.
Oncology Nurse Practitioner
An oncology nurse practitioner provides comprehensive care to patients who have been diagnosed with cancer. They collaborate with other healthcare providers including physicians to develop treatment plans for cancer patients.
Part Four How to Become a Nurse Practitioner
If you're looking to become a nurse practitioner, you'll need to complete the following steps.
Steps to Becoming a Nurse Practitioner
1. Become a Registered Nurse
The first step to becoming a nurse practitioner is becoming a registered nurse. You'll do this by enrolling in either an Associate Degree in Nursing (ADN) or Bachelor's Degree in Nursing (BSN) program.
2. Get Your Bachelor's Degree
If you don’t already hold a BSN, you may want to enroll in and earn your Bachelor’s in Nursing Science degree. Nurses who have their ADN can enroll in accelerated RN-BSN programs, many of which can be completed online. It is possible to go straight from your ADN to an MSN program if you want to skip the step of earning your Bachelor's degree, however. (More on that in step four.)
3. Gain Nursing Experience
Some nurses may choose to skip this step and go right into enrolling in a graduate program, while others choose to get a few years of experience under their belt before continuing their education.
4. Enroll in a Graduate Program (MSN or DNP)
The simplest route to becoming a nurse practitioner for RNs who already have their bachelor's degree is by earning a master’s degree.
For RNs without bachelor's degrees, there are RN-to-MSN programs. You may also see such programs called ADN-to-MSN (which means Associate Degree in Nursing to Master’s).
Some institutions offer doctoral degrees like Doctor of Nursing Practice (DNP) programs, which is the highest level of nursing education available.
5. Earn Your Advanced Practice Nursing Licensure in Practical Nursing
The specifics for NP licensure are set by the individual states, which means that you will have to search the requirements to become an NP in the state that you plan to work in. There is also talk of a national model for NP licensure, but currently, it does vary from state-to-state. You can view complete state-by-state requirements to become an NP here and be sure to check with the school you plan on attending.
6. Get Your First Nurse Practitioner Job
Congratulations! You've made it and now you're ready to find your first job as a nurse practitioner. You can work with a nurse recruiter or check out nursing job boards to help find the right position for you.
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Part Five Nurse Practitioner Salary
Nurse practitioners earn an average annual salary of $117,670 in the United States according to the U.S. Bureau of Labor Statistics as of May 2021, which places their income at more than double the average annual salary for all other occupations.
Nurse Practitioners make, on average, around $30,000 more than Registered Nurses each year. And compared to an LPN’s annual wages of $46,240, becoming an NP will more than DOUBLE your earnings.
Nurse Practitioner Salary by State
Nurse Practitioner salaries can vary by location, place of employment, experience, and specialty. So, after you become an NP, additional specializations can drive your salary up even higher, and give you more career opportunities.
Source: BLS, Data extracted June 23, 2021.
| State | Mean Annual | Avg Hourly | Cost of Living |
|---|---|---|---|
| Alabama | $99,790 | $47.98 | -8.80% |
| Alaska | $110,270 | $53.01 | +31.60% |
| Arizona | $117,480 | $56.48 | -1.95% |
| Arkansas | $106,210 | $51.06 | -11.50% |
| California | $145,970 | $70.18 | +34.80% |
| Colorado | $109,760 | $52.77 | +2.10% |
| Connecticut | $116,780 | $56.15 | +30.70% |
| Delaware | $112,230 | $53.96 | +10.80% |
| District of Columbia | $116150 | $55.84 | +49.20% |
| Florida | $101,060 | $48.58 | -1.00% |
| Georgia | $106,220 | $51.07 | -8.60% |
| Hawaii | $118,780 | $57.11 | +67.40% |
| Idaho | $113,890 | $54.76 | -10.40% |
| Illinois | $112,060 | $53.87 | -4.50% |
| Indiana | $109,940 | $52.86 | -12.10% |
| Iowa | $107,910 | $51.88 | -8.30% |
| Kansas | $104,530 | $50.25 | -9.60% |
| Kentucky | $102,460 | $49.26 | -9.60% |
| Louisiana | $111,880 | $53.79 | -5.60% |
| Maine | $111,580 | $53.64 | +12.00% |
| Maryland | $115,240 | $55.40 | +25.00% |
| Massachusetts | $126,050 | $60.60 | +34.7% |
| Michigan | $109,150 | $52.48 | -11.80% |
| Minnesota | $118,900 | $57.16 | +34.70% |
| Mississippi | $109,550 | $52.67 | -14.00% |
| Missouri | $106,870 | $51.38 | -9.20% |
| Montana | $114,370 | $54.99 | +0.80% |
| Nebraska | $107,330 | $51.60 | -8.70% |
| Nevada | $119,890 | $57.64 | +4.50% |
| New Hampshire | $112,460 | $54.07 | +0.80% |
| New Jersey | $130,890 | $62.93 | +21.00% |
| New Mexico | $117,050 | $56.28 | -4.30% |
| New York | $126,440 | $60.79 | +35.20% |
| North Carolina | $108,370 | $52.10 | -5.80% |
| North Dakota | $111,070 | $53.40 | -98.90% |
| Ohio | $105,630 | $50.78 | -7.00% |
| Oklahoma | $112,750 | $54.21 | -11.40% |
| Oregon | $118,600 | $57.02 | +15.40% |
| Pennsylvania | $111,560 | $53.64 | +2.80% |
| Rhode Island | $117,300 | $56.39 | +22.10% |
| South Carolina | $101,190 | $48.65 | +0.50% |
| South Dakota | $103,080 | $49.56 | +2.80% |
| Tennessee | $99,370 | $47.78 | -10.20% |
| Texas | $116,700 | $56.11 | -9.30% |
| Utah | $113,550 | $54.59 | -7.20% |
| Virginia | $109,660 | $52.72 | +0.20% |
| Vermont | $108,280 | $52.06 | +12.00% |
| Washington | $126,480 | $60.81 | +7.10% |
| West Virginia | $105,220 | $50.59 | +4.30% |
| Wisconsin | $113,030 | $54.34 | -3.10% |
| Wyoming | $118,810 | $57.12 | -8.30% |
Nurse Practitioner Salaries by Specialty
 |
General Nurse Practitioner | $115,800 |
 |
Family Nurse Practitioner | $105,898 |
 |
Adult-Gerontology Nurse Practitioner | $90,102 |
 |
Psychiatric Nurse Practitioner | $107,309 |
 |
Pediatric Nurse Practitioner | $121,659 |
 |
Acute Care Nurse Practitioner | $110,076 |
 |
Women's Health Nurse Practitioner | $91,454 |
 |
Orthopedic Nurse Practitioner | $100,035 |
 |
Emergency Nurse Practitioner | $113,840 |
 |
Neonatal Nurse Practitioner | $124,756 |
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Part Six Nurse Practitioner Career Outlook
Nursing is already a stable, in-demand career. But becoming a Nurse Practitioner can give you even more job security.
The BLS predicts that nurse practitioner jobs will increase by 45 percent from 2020 to 2030, which is much faster than most other careers.
The need for primary care is also expected to rise over the next five years because of the aging population. NPs will help meet this increasing demand, especially in underserved areas.
Part Seven Which Schools Have the Best NP Programs?
There are numerous NP programs throughout the country, so our panel of nurses ranked them based on reputation, certification pass rate, cost, accreditation, and acceptance rates to determine that these are some of the best options out there. Because nursing careers take different forms, the top 10 NP programs are ranked in no particular order.
Top 10 Nurse Practitioner Programs
1. University of Virginia
Annual In-State Tuition: $21,382 Annual Out-of-State Tuition: $34,054
Online: No
Program Length: 22 months
3. Duke University
Annual Tuition: $47,817 (based on per-credit tuition rate)
Online: Hybrid
Program Length: 22 months
7. University of North Carolina - Chapel Hill
Annual In-State Tuition: $23,554 Annual Out-of-State Tuition: $41,280
Online: Hybrid
Program Length: 22 months
Methodology
This list is based on a number of factors including:
- Reputation
- NCLEX pass rate
- Tuition
- Acceptance rate, when available
- Only ACEN or CCNE accredited schools are eligible
Nurse Panel
Our selection panel is made up of 3 Registered Nurses with years of experience and multiple degrees:
- Tracy Everhart, MSN, RN, CNS
- Tyler Faust, MSN, RN
- Kathleen Gaines, MSN, BSN, RN, BA, CBC
Part Eight Resources for NPs
If you’re considering taking this nursing career leap, it’s a good idea to take advantage of the resources and information offered by various national professional nursing associations. Some examples include:
- AANP - American Association of Nurse Practitioners
- AACN - American Association of Critical-Care Nurses
- ANCC - American Nurses Credentialing Center
- NCC - National Certification Corporation
Part Nine A Real Nurses NP Journey
If you're thinking of becoming an NP, your journey is going to be very different depending on where you're at now. Nurse Haskins shares her journey from CNA to NP and all the different positions she had along the way.
Find out what it's like to be a nurse practitioner, how to get there from wherever you're starting out, and what you need to know if you're considering this career.
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Exploring your career options? Check out some of these other articles:
- Physician Assistant
- Epidemiologist
- Health Care Manager
- Nursing Home Administrator
- Explore all healthcare careers
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