Advanced practice registered nurse (APRN) vs. nurse practitioner (NP)

What is an APRN?

An APRN or advanced practice registered nurse is a nursing professional with specialized education for a specific patient population or skill set. At minimum, APRNs have a registered nurse (RN) license, graduate-level education in nursing, and national certification in their role, according to the NCSBN’s APRN Consensus Model. Their education and certification prepare them to assess, diagnose, and manage patient problems, order tests, and prescribe medications, but the authority to do so comes from state licensure and law, and regulation differs from one state to another.

As the Nurse Practitioner Certification Board (NPCB) renewal handbook states, certification does not authorize practice beyond the scope permitted by applicable laws, regulations, or licensing authorities. In addition to diagnosing and treating patients, nurse practitioners emphasize disease prevention and patient education, according to the American Association of Nurse Practitioners (AANP), and certified nurse-midwives likewise provide health promotion and disease prevention, according to the American College of Nurse-Midwives (ACNM).

Becoming an APRN gives you the opportunity to work with a specific patient population, making it possible for you to focus on a specific nursing interest. For example, if you know you would like to work with children, you can pursue pediatric clinical nurse specialist certification, such as the ACCNS-P offered by AACN Certification Corporation. For those with the time and resources to pursue additional schooling, becoming an APRN may be one way to advance their career in nursing.

Other titles for APRNs: APN and ARNP

APRN is the umbrella title that the NCSBN APRN Consensus Model uses for nurse practitioners, clinical nurse specialists, certified nurse-midwives, and certified registered nurse anesthetists. Some states use a different formal title, so you may also see APN or ARNP. New Jersey, for example, uses the title advanced practice nurse (APN), as the Governor’s Office announcement of 2026 legislation on APN practice shows, while the Washington State Board of Nursing licenses advanced registered nurse practitioners (ARNPs). Because each state sets its own title and requirements, check with your state board of nursing before you enroll in a program.

Pathway to become an APRN

When deciding on which APRN program to pursue, it’s important to know which career you’d prefer. After becoming an RN, APRN education takes place at the graduate level: NCSBN describes APRNs as educated in a specific role and patient population at a master’s or post-master’s level. Your options include online MSN programs, and formats and schedules vary by school, so confirm them with each program.

Program length and structure vary by pathway. If you’re an RN without a bachelor’s degree in nursing (BSN), an online RN to MSN program is designed to move you to the master’s level. According to the American Association of Colleges of Nursing (AACN), these programs build the missing baccalaureate-level content into the program, and many award both a baccalaureate and a master’s degree; many are delivered largely online or in a blended format.

Upon completion of a graduate program such as an MSN degree, you’ll need to achieve certification in your APRN specialty. A variety of professional organizations offer certifications, including the American Nurses Credentialing Center (ANCC), the American Association of Critical-Care Nurses (AACN), and the American Midwifery Certification Board (AMCB). After becoming certified, you will need to secure a license in the state where you intend to practice. Requirements differ between states, so it’s best to check with yours beforehand.

What is a nurse practitioner?

A nurse practitioner (NP) is a type of APRN. These nursing professionals diagnose and manage acute and chronic diseases, perform physical assessments, create treatment plans, and can prescribe medications in certain states. AANP describes these duties, while the authority to prescribe comes from state law: Washington’s ARNP scope of practice rule, for example, allows licensed ARNPs to prescribe medications when prescriptive authority is granted. NPs specialize in one of several areas: adult-gerontology primary care, adult-gerontology acute care, neonatal nursing, pediatrics, psychiatric mental health, women’s health, or family nursing.

Like other APRN career paths, becoming a nurse practitioner requires completing an accredited graduate-level program (a master’s or doctoral degree, or a post-graduate certificate), passing a national certification exam, and being licensed by your state, as NCSBN and NPCB’s family nurse practitioner candidate handbook describe. It’s important to recognize the time and financial commitment necessary to become an NP, but it may be a worthy investment if you’re ready to take your nursing career to the next level.

Pathway to become a nurse practitioner

Your NP career starts off with obtaining relevant education and training. Before enrolling in any NP program, make sure it’s accredited, since NPCB requires graduation from an accredited program for family nurse practitioner certification. Accredited nurse practitioner programs vary in format and schedule, so confirm the options with each school to find one that best fits your schedule.

As an NP, you can work in a variety of specialty fields. If you’re interested in providing care to women across the lifespan, you may consider a women’s health nurse practitioner (WHNP) program. If you want to work with patients suffering from acute conditions such as respiratory distress syndrome, then you may want to look into completing one of the acute care nurse practitioner (ACNP) programs.

Upon completion of a program, you will have to become certified in your specialty by a board like the ANCC or the American Academy of Nurse Practitioners Certification Board (AANPCB), which operates as the Nurse Practitioner Certification Board (NPCB). Certification requirements often involve an exam, completion of an accredited program, an academic transcript, a minimum number of clinical hours, a nursing license, and a certification fee, as NPCB’s family nurse practitioner candidate handbook shows.

Advanced practice registered nurse (APRN) vs. nurse practitioner (NP) – what’s the difference?

An NP is one of the four types of APRNs. If you’re interested in pursuing further education and becoming an APRN, it’s helpful to know the differences between each specialty so you can choose a program that fits your interests.

Education and curriculum

NPs and CNSs complete an accredited graduate-level program, either a master’s degree, a Doctor of Nursing Practice (DNP) degree, or a post-graduate certificate, according to NCSBN. Certified nurse-midwives need at least a master’s degree to sit for the AMCB certification exam. All U.S. nurse anesthesia educational programs are at the doctoral level, according to the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Within these degree programs, students can pursue tracks for particular NP and APRN specialties. Admission requirements vary by university, so check the requirements of each program you are considering.

Accelerated nursing programs make it possible for people with a bachelor’s degree in an unrelated field to transition to nursing. AACN reports that accelerated baccalaureate programs take between 12 and 18 months and accelerated master’s programs generally about two to three years. RNs without a BSN who want a master’s degree can look at the RN to MSN pathway described above. In addition to accelerated programs, there are a number of flexible nursing degree options for students with an array of educational backgrounds. According to AACN, more than 120 dual master’s degrees combine nursing with fields such as business, public health, and health administration, and certificate programs are available to master’s graduates who want to sharpen their skills in a focus area.

The NCSBN Consensus Model calls for APRN programs to include, at a minimum, three separate graduate-level courses: advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology. Beyond that core, additional content and courses are tailored to the student’s role and patient population.

Skills and certification

NPs share much of the same education as other APRNs, all of whom complete graduate-level preparation. However, each is prepared for a specific role and patient population, and they acquire different skills to do so.

Both NPs and CNSs are APRNs educated in a specific role and patient population. NPs provide direct primary or acute care depending on their population focus, while CNSs work across three overlapping spheres of influence: patients, nurses, and healthcare systems, according to the NCSBN Consensus Model. Certification is separate for each role and population focus, so an NP and a CNS take different exams. For example, AACN offers separate ACNP and CNS board certifications to graduate-educated nurses.

Specialties

Under the category of APRNs, there are four career tracks. In this section, we dive into each one and expand on different nursing specializations so you can better understand the options available.

Advanced practice registered nurses (APRNs)

• Clinical nurse specialist (CNS): Like all APRNs, CNSs are educated in a specific patient population, such as pediatrics. They practice across the continuum of care, provide direct patient care, lead evidence-based practice, support nurses at the bedside, and help drive practice changes throughout the organization in which they work, according to the National Association of Clinical Nurse Specialists (NACNS).
• Certified registered nurse anesthetist (CRNA): CRNAs administer anesthesia and stay at the bedside of their patients before, during, and after surgical, therapeutic, diagnostic, and obstetrical procedures, according to the American Association of Nurse Anesthesiology (AANA). The role requires extensive specialized education and clinical experience, including a doctoral program. CRNAs earn more than the other APRN roles BLS reports separately, with a median annual wage of $236,590, according to May 2025 U.S. Bureau of Labor Statistics (BLS) data.
• Certified nurse midwife (CNM): As a certified nurse midwife, you’ll provide care during pregnancy, childbirth, and the postpartum period, along with gynecologic and family planning services and care of the healthy newborn, upon completion of a midwifery program, according to ACNM. Their responsibilities include assessing the well-being of the fetus, supporting lactation and infant feeding, and using screening tools and diagnostic tests, as ACNM’s core competencies describe. This advanced nursing path may be a good fit for those interested in studying women’s reproductive health.
• Nurse practitioner (NP): NPs provide a full range of primary, acute, and specialty health care services, including diagnosing and treating acute and chronic conditions and educating patients on disease prevention, according to AANP. Whether an NP can prescribe medicine or practice independently depends on the requirements of the state where they are licensed, since states have not all adopted the same regulatory framework.

Nurse practitioner specialties

• Acute care nurse practitioner (ACNP): ACNPs can specialize in adult-gerontology acute care or pediatric acute care. AACN Certification Corporation describes adult-gerontology ACNPs as caring for acutely ill young adults, older adults, and frail elderly patients, including those with exacerbations of chronic illness, while the Pediatric Nursing Certification Board (PNCB) describes pediatric ACNPs as caring for infants, children, adolescents, and young adults with acute, complex, critical, and chronic illness.
• Family nurse practitioner (FNP): In the 2024 AANP NP Workforce Survey, 68.7% of the 10,275 NPs sampled held a family primary care certification, according to AANP’s 2024 Nurse Practitioner Practice Report; some NPs hold multiple certifications, and the report does not state a response rate. FNPs are educated to care for patients across the lifespan, from newborns to older adults, assessing, diagnosing, and planning and evaluating care with an emphasis on health promotion and disease prevention, according to NPCB’s family nurse practitioner candidate handbook. You can explore online FNP programs as one option.
• Pediatric nurse practitioner (PNP): Primary care PNPs care for children from birth through young adulthood, providing well-child care and managing common acute illnesses and chronic conditions, according to the PNCB. Their settings include private practices, ambulatory and outpatient clinics, school-based clinics, hospitals, and federally qualified health centers.
• Women’s health nurse practitioner (WHNP): WHNPs provide obstetric, gynecologic, and primary care to women across the life cycle, according to the National Certification Corporation (NCC). Their services include contraceptive care, age-appropriate cancer screening, and prenatal and postpartum care.
• Psychiatric and mental health nurse practitioner (PMHNP): According to the American Psychiatric Nurses Association (APNA), psychiatric-mental health APRNs assess, diagnose, and treat individuals and families with psychiatric and substance use disorders across the lifespan. As a PMHNP you belong to a team of healthcare experts dedicated to making a critical difference in their patients’ lives.

Choosing an APRN role

Your interests and the patients you want to serve usually point toward one path. A few questions can help you narrow the choice:

• Do you want to care for a defined patient population? NPs are educated and certified in a role and in one of six population foci, including family/individual across the lifespan, adult-gerontology, pediatrics, and psychiatric/mental health.
• Are you drawn to anesthesia and surgical care? CRNAs train in nurse anesthesia programs that are at the doctoral level and require one to two years of full-time critical care nursing experience, according to COA.
• Do you want to focus on pregnancy, childbirth, and women’s health? Certified nurse-midwives earn certification through the American Midwifery Certification Board (AMCB).
• Do you want to shape how nursing care is delivered across a unit or organization? The clinical nurse specialist role, described above, centers on improving patient outcomes and nursing care across the patient, nurse, and system spheres, according to the NCSBN Consensus Model.

Whichever role you choose, confirm the education, certification, and licensure requirements with your state board of nursing before you enroll, because regulation differs from one state to another.

Scope and work setting

In medicine, scope of practice is the range of responsibilities a practitioner is authorized to take on. The scope of practice varies for each APRN specialty. According to NCSBN, APRNs are prepared by education and certification to assess, diagnose, and manage patient problems, order tests, and prescribe medications, although states have not all adopted the same regulatory framework. Some APRNs, including nurse practitioners, can prescribe medications and practice independently in certain states. In Washington, for example, state regulation defines the ARNP as a licensed independent practitioner, and the Washington State Board of Nursing adds prescriptive authority to an ARNP license through a separate application. Across the board, these nurses provide important, comprehensive care for their patients and have a high level of medical knowledge.

Depending on their role, APRNs practice in settings such as hospitals, clinics, private practices and physician offices, ambulatory surgery centers, and community and public health settings, according to AANP, AANA, and ACNM. Some certified nurse-midwives also provide care in patients’ homes and in birth centers.

Salary and career outlook

Advanced nursing roles also have an above-average earning potential compared with registered nurses overall. The list below shows the U.S. Bureau of Labor Statistics (BLS) Occupational Employment and Wage Statistics (OEWS) national estimates for May 2025 for each APRN role that BLS reports as a separate occupation, with registered nurses for comparison. Wages are median annual wages, and employment is estimated national employment.

• Registered nurses (all): $97,550 median annual wage; 3,379,720 employed
• Nurse practitioners (NPs): $132,300 median annual wage; 323,040 employed
• Nurse midwives (CNMs): $134,040 median annual wage; 7,920 employed
• Nurse anesthetists (CRNAs): $236,590 median annual wage; 51,840 employed

Income for these professions varies by state and city. According to BLS OEWS May 2025 state estimates for nurse practitioners, NPs have the highest estimated employment in Texas (25,970), California (25,120), New York (22,890), Florida (21,790), and Ohio (15,400) — but earn the highest median annual wages in California ($168,520), New Jersey ($159,310), Washington ($156,100), Oregon ($155,680), and Alaska ($155,170). These rankings are our calculations from BLS May 2025 state estimates.

Continuing education requirements

Once you complete your APRN certification, you will have to renew it regularly. Certifying bodies set their own renewal cycles. NPCB, for example, grants family nurse practitioner certification for five years, and family nurse practitioners can renew by examination or by completing practice hours and continuing education, according to NPCB’s renewal handbook. NPCB requires current, active nurse licensure throughout the renewal process.

If you’re interested in furthering your education after completing a master’s program, a DNP program may be for you. The DNP is a practice-focused terminal degree, and AACN reports that DNP programs prepare nurse leaders at the highest level of nursing practice to improve patient outcomes and translate research into practice, with coursework in areas such as evidence-based practice, quality improvement, and systems leadership. Whether you’re hoping to continue clinical practice after graduation or move into a leadership role, check each program’s focus to see whether it includes preparation for an advanced practice role.