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Nurse Practitioners: Scope of Practice per State
- Madison Loomis
- Sep 10, 2024
- 3 min read
Here’s an overview of the Nurse Practitioner (NP) laws in each state regarding collaborative agreements and the number of NPs per supervising physician versus states where NPs can practice independently:
Full Practice States (Independent Practice)
In these states, NPs can evaluate, diagnose, interpret diagnostic tests, and initiate treatment plans, including prescribing medications without a supervising physician.
1. Alaska
- Independent practice
- No collaborative agreement required
2. Arizona
- Independent practice
- No collaborative agreement required
3. Colorado
- Independent practice
- No collaborative agreement required
4. Connecticut
- Independent practice after three years and 2,000 hours of collaboration with a physician.
5. Hawaii
- Independent practice
- No collaborative agreement required
6. Idaho
- Independent practice
- No collaborative agreement required
7. Iowa
- Independent practice
- No collaborative agreement required
8. Maine
- Independent practice after 2 years of supervision or collaboration.
9. Montana
- Independent practice
- No collaborative agreement required
10. Nevada
- Independent practice after two years or 2,000 hours of supervised practice.
11. New Hampshire
- Independent practice
- No collaborative agreement required
12. New Mexico
- Independent practice
- No collaborative agreement required
13. North Dakota
- Independent practice
- No collaborative agreement required
14. Oregon
- Independent practice
- No collaborative agreement required
15. Rhode Island
- Independent practice
- No collaborative agreement required
16. South Dakota
- Independent practice after 1,040 hours of collaboration with a physician.
17. Vermont
- Independent practice
- No collaborative agreement required
18. Washington
- Independent practice
- No collaborative agreement required
19. Wyoming
- Independent practice
- No collaborative agreement required
20. District of Columbia (D.C.)
- Independent practice
- No collaborative agreement required
Reduced Practice States
NPs have reduced ability to engage in at least one element of NP practice and need a collaborative agreement or supervision for certain practice elements such as prescribing medications.
1. Alabama
- Requires a collaborative agreement for prescribing
- No specified physician-to-NP ratio
2. Arkansas
- Requires a collaborative agreement
- No more than 6 NPs per supervising physician
3. Illinois
- Requires a collaborative agreement for certain practices
- No more than 5 NPs per supervising physician
4. Kentucky
- Requires a collaborative agreement for prescribing
- No limit on NP-to-physician ratio
5. Louisiana
- Requires a collaborative agreement
- No specified physician-to-NP ratio
6. Mississippi
- Requires a collaborative agreement
- No more than 4 NPs per supervising physician
7. New Jersey
- Requires a collaborative agreement for prescribing
- No specified physician-to-NP ratio
8. Ohio
- Requires a collaborative agreement
- No more than 5 NPs per supervising physician
9. Utah
- Requires a collaborative agreement for prescribing
- No more than 4 NPs per supervising physician
10. West Virginia
- Requires a collaborative agreement for the first 3 years of practice
- No specified physician-to-NP ratio
Restricted Practice States
In these states, NPs are required to have physician oversight for diagnosing, treating, and prescribing medications. They need to collaborate with or be supervised by a physician.
1. California
- Requires physician oversight for most practice aspects
- No more than 4 NPs per supervising physician
2. Florida
- Requires physician oversight for most practice aspects
- No more than 4 NPs per supervising physician
3. Georgia
- Requires a collaborative agreement
- No more than 4 NPs per supervising physician
4. Missouri
- Requires a collaborative agreement
- No more than 3 NPs per supervising physician
5. North Carolina
- Requires a collaborative agreement
- No more than 4 NPs per supervising physician
6. Oklahoma
- Requires a collaborative agreement
- No more than 6 NPs per supervising physician
7. South Carolina
- Requires a collaborative agreement
- No more than 3 NPs per supervising physician
8. Tennessee
- Requires a collaborative agreement
- No more than 4 NPs per supervising physician
9. Texas
- Requires a collaborative agreement
- No more than 7 NPs per supervising physician
10. Virginia
- Requires a collaborative agreement for the first 5 years of practice
- No more than 6 NPs per supervising physician
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