What states allow nurse practitioners to practice independently

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New York, Kansas, Massachusetts, and Delaware Become the latest States to Adopt Full Practice Authority for Nurse Practitioners

Client Alert

While the COVID-19 pandemic certainly created many obstacles and hardships, it also created many opportunities to try doing things differently. This can be seen in the instant rise of remote work opportunities, telehealth visits, and virtual meetings. Many States took the challenges of the pandemic and turned them into an opportunity to adjust the regulations governing licensed professionals, including for advanced practice registered nurses (APRNs). 

What states allow nurse practitioners to practice independently

On April 15, 2022, Kansas became the latest state to remove practice restrictions on nurse practitioners and allow them to practice completely independent of any regulatorily mandated contractual relationship with a physician. This was very shortly after similar changes were made in New York, Massachusetts, and Delaware. In total, 26 States, the District of Columbia, and two U.S. territories (Guam and Northern Mariana Islands) now permit nurse practitioners to practice without any mandated collaborative agreement or supervision. Many other States, including Ohio, are currently evaluating legislation to implement full practice authority for APRNs. A map illustrating the current position of all U.S. States and territories regarding full practice authority can be found here.

It should be noted that each full practice authority State is different with regards to the requirements to practice independently. For example, some States require a transition to practice period where the APRN practices under supervision or regulatory collaboration for a minimum period of time before being licensed to practice independently.

The trend towards adopting full practice authority for APRNs will have a direct impact on the number of patient care roles that will be filled by APRNs. Over the course of seven years (as reported in 2020), the number of nurse practitioners in the U.S. more than doubled. Additionally, the U.S. Department of Labor expects the number of jobs held by nurse practitioners, CRNAs, and certified nurse midwives to increase 45% between 2020 and 2030.

If you have questions about APRN practice rules or starting an APRN-driven business, please don’t hesitate to contact Jeana Singleton by email at: , or by phone at: (330) 253-2001 or another member of the Health Law Department at Brennan, Manna & Diamond.

Posted by Jeana M. Singleton


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How many states can NP work independently?

Scope of practice guidelines for advanced nursing professions vary by state. Currently, 22 states and the District of Columbia have approved “full practice” status for nurse practitioners, open_in_new a provision that allows them to assess, diagnose, interpret diagnostic tests, and prescribe medications independently.

What states do NP have autonomy?

States Where NPs Can Practice Independently.
Alaska. In Alaska, all NPs have FPA. ... .
Arizona. In Arizona, licensure through the Arizona Board of Nursing includes full prescriptive authority. ... .
Colorado. ... .
Connecticut. ... .
Delaware. ... .
District of Columbia. ... .
Hawaii. ... .
Idaho..

Which states are the most restrictive for nurse practitioners?

The Best & Worst States for Nurse Practitioners: Scope of Practice.

What states are full practice states?

Currently, Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Dakota, Oregon, Rhode Island, South Dakota, Vermont, Washington, and Wyoming are full practice authority states.