What states can a nurse practitioner open their own practice

What states can a nurse practitioner open their own practice
I am often asked the Best State for Nurse Practitioner Practice?  The best state to own your own practice/business? Let me start off by saying that you can have your own practice in any state by following what ever rules and regulations (scope of practice) are in place.

In addition to looking at practice acts for each state, you’ll want to look at the rules and regulations for business for that state. Can you own a practice outright? Do you have to own the practice with a physician? Who else can own a practice with you? What other potential barriers are there to owning a practice or any other business in your state?

Obviously the first place to start is going to be with your own state’s board of nursing to learn about your own practice act. Make sure you check at least annually, as SOP is constantly being update. What if you are looking for other states? My go to reference is the Pearson Report, which is updated annually and an excellent business resource.

That said, according to my list and information I have from NPs around the country, states without any sort of collaboration are included in the image below. Those with an asterisk are those with independence after meeting a requirement. This slide is from a presentation I did last year, which will be updated to reflect changes that took place in 2011.

What states can a nurse practitioner open their own practice

When you are looking for a place to practice, considerations including SOP and business climate are certainly important. However, look at all the factors that are important to you and your family and make the choice from there. You’ll be much happier if your business fits into your lifestyle and reflects what is important to you as a clinician. After all, it is your practice.

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Dreaming of opening your own clinic? Or, perhaps you are tired of handing the red tape associated with practicing as a nurse practitioner? Laws regulating NP practice vary significantly between states and can affect what your job looks like on a day to day basis. For example, some states require NPs to work within a certain radius of an overseeing physician and others regulate nurse practitioner’s prescribing abilities. One state’s laws may permit you to open your own clinic with ease while another’s could have you jumping through hoops.

Regardless of your reasons for seeking independence in your practice, living in a nurse practitioner friendly state can certainly give you more room to grow in your NP career. Which states fare best when it comes to nurse practitioner scope of practice laws?

1. Washington State

Residents of Washington State have an overall liberal mindset. You can’t visit Seattle, after all, without seeing a some blue hair and a few wannabe rockers pining away for the 90’s. This independent mindset extends to nurse practitioners practicing in the state. Physician involvement is not required in practice or prescribing for NPs living in Washington State. Furthermore, Washington was the first state, and remains one of the few in the nation, that currently allows nurse practitioners to prescribe medical marijuana.

2. New Mexico

New Mexico’s Governor, Susana Martinez, is a big fan of nurse practitioners so the state has scope of practice laws to match. NPs practicing in New Mexico may practice and prescribe independently of physician oversight. Not only are New Mexico’s laws regulating nurse practitioners among the most favorable in the nation, the state is actively recruiting NPs to its ranks. Recently, New Mexico implemented an ad campaign in neighboring Texas encouraging nurse practitioners to relocate to neighboring New Mexico where scope of practice laws are more favorable. As an added bonus, New Mexico also offers NPs practicing in rural areas a $3,000 tax credit.

3. Oregon

Oregon has long recognized the value of nurse practitioners to healthcare. For example, the state began allowing NPs to prescribe controlled substances as early as 1979. Nurse practitioners working in Oregon may both practice and prescribe without physician oversight. Aspiring NPs should note that in Oregon, new nurse practitioners are required to have at least 384 hours of registered nursing experience outside of the academic setting in order to obtain a nurse practitioner license, a requirement not held by most other states.

4. Alaska

Like Oregon, Alaska has a rich history of supporting nurse practitioners. Alaska began adapting scope of practice laws granting NPs more freedom as early as the 1980’s and hasn’t looked back since. Physician involvement in diagnosing, treating, and prescribing for patients is not required for nurse practitioners practicing in Alaska. Furthermore, new NPs may begin practicing immediately upon graduation, even while certification exam results are pending. This allows for a smooth transition from education to practice.

5. New Hampshire

“Live free or die”, New Hampshire’s state motto rings true for nurse practitioners practicing in the state. Like all other states on our list, New Hampshire does not require physician supervision or collaboration in practice or prescribing when it comes to NPs. The state also has a provision for newly graduated nurse practitioners allowing a temporary license to practice before sitting for the national certification exam. This gives new nurse practitioners a seamless transition from education to practice.

6. Arizona

Arizona completes our list of most nurse practitioner friendly states. Nurse practitioners working in Arizona enjoy the freedom to practice and prescribe independently. Within this freedom, however, state law specifies that NPs must practice only within their area of certification, they should not “exceed the limits” of their advanced practice specialty.

Overall, west is best when it comes to nurse practitioner scope of practice regulations. Five of the top six most favorable states for NP practice lie in the western half of the country. While these states stand out above others when it comes to offering nurse practitioners freedom in their practice, more and more states are jumping on the NP independence bandwagon. Soon, we could see all 50 states mirroring the practice and prescribing laws of the nation’s most nurse practitioner friendly locales.

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Can a NP open their own practice in Texas?

Yes. National certification is one of the requirements for licensure as an APRN in Texas. However, you must meet all of the requirements that are outlined in Rules 221.3 and 221.4 in order to be licensed, practice, or hold yourself out as an APRN in Texas.

Which states are the most restrictive for nurse practitioners?

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

Can NP practice independently in NC?

Is physician supervision required for Nurse Practitioner practice in North Carolina? Yes. a collaborative practice agreement (CPA) with a supervising physician licensed by the North Carolina Medical Board is required for Nurse Practitioner approval to practice in North Carolina.

Can NP practice independently in Virginia?

What does this mean for NPs in Virginia? Practically speaking, if a nurse practitioner meets the qualifications and makes the appropriate filings with the Board of Nursing, he or she can open up an independent practice to provide care in their community.