2025 State by State Scope of Practice: Nurse Practitioner
Understanding Nurse Practitioner Scope of Practice in 2025
Nurse practitioners (NPs) are a category of advanced practice registered nurses (APRNs) whose roles are defined by state-specific Nurse Practice Acts and regulated by State Boards of Nursing (BONs). While NPs are increasingly vital in closing healthcare access gaps across the U.S., their scope of practice (SOP) varies significantly by state, which can create challenges - particularly for those relocating or practicing via telehealth across state lines.
Understanding these variations is essential. Practicing beyond one’s legal SOP can lead to disciplinary action from the state BON, revocation of licensure, and potential malpractice liability. NPs must stay informed of their current state's rules to ensure compliant, effective practice.
What Is “Scope of Practice”?
In healthcare, a professional’s scope of practice outlines the services and responsibilities they’re legally permitted to perform. For NPs, this includes the ability to assess patients, diagnose conditions, prescribe medications, and develop treatment plans.
Each state defines SOP differently. According to the American Association of Nurse Practitioners (AANP), there are nine core elements of NP SOP laws, and not all states recognize the full range of NP authority - making standardization a key issue in the profession.
Common Nurse Practitioner Specializations
NPs can pursue various specializations, each serving different populations and clinical environments. Common roles include:
- Family Nurse Practitioner (FNP) – Provides comprehensive care across the lifespan, focusing on prevention and wellness.
- Women’s Health Nurse Practitioner (WHNP) – Offers specialized reproductive and primary care for women.
- Adult-Gerontology Primary Care NP (AGPCNP) – Treats adolescents to seniors with chronic and acute conditions.
- Adult-Gerontology Acute Care NP (AGACNP) – Delivers critical care, often in hospitals and ICUs.
- Pediatric Nurse Practitioner (PNP) – Manages the care of children and adolescents.
- Neonatal Nurse Practitioner (NNP) – Specializes in treating newborns in neonatal intensive care units (NICUs).
- Psychiatric Mental Health Nurse Practitioner (PMHNP) – Provides mental health assessments, therapy, and medication management.
State-by-State Scope of Practice Differences
State laws determine whether an NP works independently or must collaborate with or be supervised by a physician. These practice environments fall into three categories:
✅ Full Practice (26 States + D.C. + Guam)
NPs can evaluate, diagnose, and prescribe without physician oversight. States include:
- Colorado, New Mexico, Oregon, Hawaii, Alaska, Washington, Arizona, Massachusetts, and others.
View the full list of full practice states.
⚠️ Reduced Practice (13 States)
NPs have limited autonomy and require a collaborative agreement with a physician for some aspects of care.
Examples: New York, New Jersey, Pennsylvania, Wisconsin.
🚫 Restricted Practice (11 States)
NPs must operate under direct physician supervision.
Examples: California, Texas, Florida, North Carolina.
🎯 According to the AANP, removing restrictions and granting full practice authority can help reduce healthcare provider shortages, especially in rural and underserved areas.
The Push for National Uniformity: The APRN Compact
To address practice inconsistencies, the APRN Compact was developed by the National Council of State Boards of Nursing (NCSBN). Once implemented, it would allow NPs to practice in all compact states with a single multistate license — similar to the RN compact.
As of 2025, only Utah, Delaware, North Dakota, and South Dakota have enacted APRN Compact legislation. More states are expected to follow in the coming years. For updates, visit the NCSBN APRN Compact Map.
Legal and Regulatory Considerations
Each state’s Board of Nursing (BON) enforces its Nurse Practice Act, licensing requirements, and SOP. Some states require collaborative agreements, which NPs must regularly review to avoid legal risk. The American Nurses Association (ANA) actively tracks legislation that could affect NP practice and lobbies for greater autonomy and equity in care delivery.
NP Recruitment Support from Incredible Health
If you’re a healthcare employer seeking qualified NPs and APRNs, consider working with Incredible Health. This nurse hiring platform streamlines the recruitment process, offering access to a nationwide talent pool of credentialed, pre-screened nurses. They also provide workforce data, market salary insights, and automated matching to reduce time-to-hire.
You can schedule a demo with Incredible Health to see how it can support your organization’s nurse recruitment goals.
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