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Nurse practitioner (NP)

A nurse practitioner (NP) is a nurse with a graduate degree in advanced practice nursing. This type of provider may also be referred to as an ARNP (Advanced Registered Nurse Practitioner) or APRN (Advanced Practice Registered Nurse).

Types of health care providers is a related topic.

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The NP is allowed to provide a broad range of health care services, which may include:

• Taking the person's history, performing a physical exam, and ordering laboratory tests and procedures
• Diagnosing, treating, and managing diseases
• Prescribing medicines and writing prescriptions
• Coordinating referrals
• Providing education on disease prevention and healthy lifestyles
• Performing certain procedures, such as a bone marrow biopsy or lumbar puncture

Nurse practitioners work in a variety of specialties, including:

• Cardiology
• Emergency
• Family practice
• Geriatrics
• Neonatology
• Nephrology
• Oncology
• Pediatrics
• Primary care
• Psychiatry
• School health
• Women's health

Their range of health care services (scope of practice) and privileges (authority granted to a provider) depends on laws in the state in which they work. Some nurse practitioners may work independently in clinics or hospitals without doctor supervision. Others work together with doctors as a joint health care team.

Like many other professions, nurse practitioners are regulated at two different levels. They are licensed through a process that takes place at the state level under state laws. They are also certified through national organizations, with consistent professional practice standards across all states.

LICENSURE

The laws on NP licensure vary greatly from state to state. Today, more states are requiring NPs to have a master's or doctorate degree and national certification.

In some states, NP practice is completely independent. Other states require that NPs work with an MD for prescriptive practice privileges or to get licensed.

CERTIFICATION

National certification is offered through various nursing organizations (such as the American Nurses' Credentialing Center, Pediatric Nursing Certification Board, and others). Most of these organizations require that NPs complete an approved master's or doctorate-level NP program before taking the certification exam. The exams are offered in specialty areas, such as:

• Acute care
• Adult health
• Family health
• Geriatric health
• Neonatal health
• Pediatric/child health
• Psychiatric/mental health
• Women's health

To be recertified, NPs need to show proof of continuing education. Only certified nurse practitioners may use a "C" either in front of or behind their other credentials (for example, Certified Pediatric Nurse Practitioner, FNP-C, Certified Family Nurse Practitioner). Some nurse practitioners may use the credential ARNP, which means advanced registered nurse practitioner. They may also use the credential APRN, which means advanced practice nurse practitioner. This is a broader category that includes clinical nurse specialists, certified nurse midwives, and nurse anesthetists.

References

Association of American Medical Colleges website. Careers in medicine. www.aamc.org/cim/specialty/exploreoptions/list/. Accessed July 18, 2022.

American Association of Nurse Practitioners website. What's a nurse practitioner (NP)? www.aanp.org/about/all-about-nps/whats-a-nurse-practitioner. Accessed July 18, 2022.

Review Date: 7/25/2022  

Reviewed By: Linda J. Vorvick, MD, Clinical Professor, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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