How to Become a Nurse Practitioner

A nurse practitioner, or NP, is an advanced practice registered nurse (APRN) that provides primary care and other healthcare services to patients. Nurse practitioners may choose a specialty or focus like women’s health, neonatal care or focus on acute or primary care for adults or children.

Nurse practitioners may examine patients, provide diagnoses, prescribe medication and treatment and other duties. While these responsibilities may vary with states, be sure to check with your state of practice board for more information.

Yes. Some nurse practitioners are given prescriptive authority to varying degrees across the United States. Some states allow a larger degree of prescriptive authority to nurse practitioners, while others regulate this more closely.

View our state-by-state breakdown of NP prescriptive authority and check with your state’s board of nursing for the most up-to-date information.

Nurse practitioners are likely required to earn a graduate degree in nursing, plus pursue national certification and state licensure. The time it takes to become a nurse practitioner depends on one’s past education, experience and type of enrollment in these nursing programs.

APRN, which stands for advanced practice registered nurse, is an umbrella term for nursing professionals who have earned a master’s or doctoral degree in order to take on advanced roles in healthcare. According to the National Council of State Boards of Nursing, APRNs include the following: clinical nurse specialists (CNS), nurse practitioners (NP), certified nurse midwife (CNM) and nurse anesthetists (CRNA).

Many RNs who are looking to advance their careers earn a master’s or doctoral degree through specialized APRN programs, like a certified nurse midwife program. In addition to having more autonomy and an increased scope of practice, nurses may see an increase in pay as a result of becoming an APRN.

National certification for NPs is available from various professional associations, depending on your chosen area of specialization. National organizations that certify NPs include the Pediatric Nursing Certification Board, the American Association of Nurse Practitioners, and the American Nurses Credentialing Center, which is a subsidiary of the American Nurses Association. Eligibility for certification typically requires at least an RN license, a degree from an accredited institution and a certain number of supervised clinical hours.

Each certifying body has a set of eligibility requirements for the nurse practitioner certifications that they offer. Exams for the various certifications also differ so it’s important to research what prep tools are available and develop a study plan. 

To prepare for the ANCC nurse practitioner certification exam, review the ANCC General Testing and Renewal Handbook (PDF, 373 KB), which contains a general overview of testing processes and procedures and information on maintaining certification. ANCC provides test content outlines that identify the areas included on the examination. This serves as your roadmap to the exam, including the percentage and number of questions in each of the major categories of the scored portion of the examination. You can print the outline and take notes on each objective to guide your study process.

In addition to the content outline, other detailed information related to specific exams is available, including a test reference list and sample test questions with answers. The ANCC website has more information and resources on nursing certification. Once you review them, you can make a study plan and stick to your schedule while also incorporating breaks to avoid getting overwhelmed. 

If you’re interested in pursuing an NP career with no prior nursing experience, you can take advantage of a wide variety of programs designed for aspiring professionals. Direct-entry, accelerated, bridge and online options offer students with different academic backgrounds the chance to take necessary foundational courses in nursing as part of the master’s curriculum to streamline their degree.

Direct-entry nurse practitioner programs allow non-nurses to earn a graduate degree in nursing. These accelerated programs often take around four years, with the general prerequisite nursing courses completed in the first two years of study. Once you pass these courses and become eligible for nursing licensure, you can complete your degree and earn an MSN.

Nurse practitioners and medical doctors are committed to preventing disease and promoting well-being. Both professionals are able to diagnose conditions, treat patients for ailments and write prescriptions. However, states and cities have differing laws and regulations that may require physicians to oversee NPs. Still, some states allow NPs to work without oversight.

The key differences in the two occupations lie in education and credentials.

Both nurse practitioners and physician assistants (PAs) are licensed healthcare providers. While neither is a medical doctor, each takes on the role of assessing patients, making diagnoses and prescribing medication. Both professions offer the opportunity to work in nearly all medical settings, but in many states, the NP is granted permission to work independently of physicians, whereas a physician assistant likely works under supervision or in a collaborative relationship with a physician (PDF, 533KB).

In terms of education, an NP attends a nursing school to attain (and continually maintain) an RN certification, while a PA goes to a medical school or center of medicine. From there, NPs will follow a patient-centered model, focused on wellness, disease prevention and health education, while physician assistants follow a disease-centered model, focused on the biologic and pathologic components of health.

Certification requirements for NPs and PAs vary based on the national certifying agency’s requirements.

Both nurse practitioners and registered nurses work closely with patients to monitor health and manage treatment for acute and chronic illnesses. However, the educational qualifications, work environments and responsibilities can be vastly different.

RNs can enter the profession with a minimum of an associate degree in nursing (ADN), but NPs must have either a master’s or doctoral degree. More than 60% of RNs work in hospitals, while many NPs work in physicians’ offices.
The biggest difference between the two professions is the level of autonomy given to NPs. In most states, they can see patients on their own or refer them to a doctor or specialist as necessary. They can also diagnose illnesses and prescribe medications, but an RN cannot.

Sometimes, RNs go on to become NPs to further their careers, since salaries and leadership opportunities tend to be better. According to the BLS, registered nurses earned a median pay of $75,330 in 2020, while NPs earned a median annual salary of $111,680. The difference in salary is not just due to an extended role and scope of practice. Other factors, such as the employer, can play a role in how much an NP earns.

There are two main post-baccalaureate degrees for NPs to pursue: the Master of Science in Nursing and the Doctor of Nursing Practice. 
Currently, the MSN remains the minimum educational standard for advanced practice nursing roles. However, some nursing candidates may choose to look beyond this degree in the pursuit of meeting the increasing demands of patients, improving the quality and outcomes of care, and achieving senior-level leadership positions in clinical care and nursing systems.

The American Association of Colleges of Nursing recommends that aspiring NPs pursue the doctorate for just this reason, stating the DNP degree widens the candidate’s understanding of advanced nursing issues and better prepares them for the future of the profession. Overall, those with DNPs move to affect the efficiency and safety of care while contributing insights to wider applications of health policy. Generally, doctoral-trained nurses generally earn higher salaries and may enjoy more opportunities for advancement.