NP vs Advanced Practice Registered Nurse (APRN)

The nursing field is an alphabet soup of distinctive titles. When distinguishing the differences between nurse practitioners (NPs) and advanced practice registered nurses (APRNs), it helps to think of a charm bracelet. In this metaphor, APRNs are the bracelet, and NPs are one of four available charm specialties. Each state board of nursing (SBON) has unique definitions. The four common APRN titles are: nurse practitioners (NPs), certified registered nurse anesthetists (CRNA), clinical nurse specialists (CNS), and certified nurse-midwives (CNM). 

What do NPs have in common with APRNs? For starters, all APRNs have earned a master of science in nursing (MSN) or doctorate of nursing practice (DNP) degree. Second, all NPs and APRNs must hold a current RN license. Lastly, APRNs must pass a certification exam with an APRN specialty. In graduate degree programs and board certification exams, APRNs can specialize in specific or general fields of nursing. Examples of specialty nursing titles include: cardiology nurse practitioners, pediatric nurse anesthetists, and acute care clinical nurse specialists. 

In short, all NPs are APRNs, but not all APRNs are NPs. The US Bureau of Labor Statistics (BLS) classifies three APRN titles into one occupational category and shows that nurse practitioners, nurse anesthetists, and nurse midwives are poised for much faster than average growth in the coming decade. From 2021 to 2031, APRNs will grow 40 percent, eight times faster than the national average (5 percent), creating 118,600 new positions. 

Read on to learn more about the similarities, differences, and overlaps between nurse practitioners (NPs) and advanced practice registered nurses (APRNs), including a side-by-side comparison chart.

Similarities, Differences, and Overlap: NP vs. APRN

A clear similarity between NPs and APRNs is both titles require a master’s or doctoral degree in nursing. There are many pathways for nurses with varying educational backgrounds to become an NP or an APRN. For example, nurses with associate’s degrees can complete an accelerated bachelor of science in nursing (BSN). Nurses with bachelor’s degrees can complete a BSN-to-MSN or BSN-to-DNP program. There are even BSN-to-MSN and BSN-to-DNP programs for bachelor’s degree holders without nursing degrees. 

That said, there are significant differences in MSN and DNP programs for nurse practitioners. For example, an MSN or DNP program may offer nurse practitioner specializations in pediatrics, adult-gerontology, or psychiatric-mental health. NP programs can also provide specialization tracks for the other three APRN branches, preparing graduates for work as nurse anesthetists, clinical nurse specialists, and certified nurse-midwives. By comparison, DNP programs may emphasize leadership and research skills rather than the aforementioned clinical specialties. 

A second similarity is that all NPs must hold valid and unencumbered registered nurse (RN) licenses. Licensing requirements vary by state, but most states require RNs and APRNs to graduate from an accredited nursing degree program (BSN, MSN, or DNP), meet clinical hour requirements, and pass the NCLEX exam. 

Conversely, APRNs will hold unique certifications depending on their area of specialization. For example, a psychiatric-mental health nurse practitioner (PMHNP) is an APRN with 2,000 clinical hours in psychiatric-mental health nursing and a board-certified credential, such as the Psychiatric-Mental Health Nursing Certification (PMH-BC) offered by the American Nurses Credentialing Center. 

The similarities, differences, and overlap in this profession are indicators that nursing education, licensure, and certification are well-regulated at the state and national levels to provide the best possible healthcare for patients. 

The side-by-side comparison chart below outlines critical knowledge necessary to pursue an NP or other type of APRN nursing specialty.

Side-by-Side Comparison: APRN vs NP

Nurse Practitioner (NP)Advanced Practice Nurse Practitioner (APRN) 
Number Practicing in the United StatesIn 2021, there were 246,700 nurse practitioners employed in the United States (BLS 2022). 

In 2021, there were 271,900 APRNs employed in the United States (BLS 2022):

  • Nurse practitioners: 246,700
  • Nurse anesthetists: 45,200
  • Nurse midwives: 8,100
Pay 

Average hourly wage: $56.75 per hour

Average annual salary: $118,040 per year (BLS May 2021)

  • 10th percentile: $79,470
  • 25th percentile: $99,540
  • 50th percentile (median): $120,680
  • 75th percentile: $129,680
  • 90th percentile: $163,350

Average hourly wage: $56.75 per hour

Median annual salary: $123,780 per year (BLS May 2021)

  • 10th percentile: $79,870
  • 50th percentile (median): $123,780
  • 90th percentile: more than $200,540
Expected National Job Growth (2021-2031)46 percent40 percent
Anticipated Number of New Positions Available by 2031112,700118,600
Educational Requirements
Degrees Available

Aspiring NPs can choose an accredited general or specialized MSN, DNP, or post-master’s certificate program. Examples include:General:

  • Master of science in nursing (MSN)Doctorate of nursing practice (DNP)Post-master’s certificate program

Specialized:

Future APRNs must earn an accredited MSN or DNP in a specialty area:

  • Nurse practitioner (NP)
  • Certified registered nurse anesthetist (CRNA)
  • Clinical nurse specialist (CNS)
  • Certified nurse-midwifery (CNM)

An MSN degree-holder can choose to specialize in a specific area with a post-master’s certificate program.

Program Details

Degree programs for NPs typically take 1-5 years to complete:

  • BSN-to-MSN programs can take 1-2 years
  • BSN-to-DNP programs can take 3-4 years
  • MSN-to-DNP can take 2-5 years

NP programs include on-campus or online didactic courses, and in-person clinical rotations in primary care or specialty areas.

Some programs require a terminal project such as a capstone or thesis for degree completion.

Depending on the current level of education and clinical experience, APRN MSN and DNP degree programs can take 1-5 years to complete.

As with NP programs, APRN programs are comprised of lecture courses, and in-person clinical rotations with specializations available for nurse practitioners, nurse anesthetists, clinical nurse specialists, and certified nurse midwives.

Terminal projects may or may not be required to complete an APRN graduate program.

Nursing Program Accreditation

NPs must complete a graduate (MSN) or doctoral (DNP) nursing program accredited by:

  • Commission on Collegiate Nursing Education (CCNE) or
  • Accreditation Commission for Education in Nursing (ACEN)

APRNs must complete a graduate (MSN) or doctoral (DNP) nursing program accredited by:

  • Commission on Collegiate Nursing Education (CCNE)
  • Accreditation Commission for Education in Nursing (ACEN)
Four On-Campus Nursing Programs

These four schools offer CCNE or ACEN-accredited on-campus nurse practitioner programs:

The following four schools offer CCNE- or ACEN-accredited on-campus graduate and doctoral APRN programs:

Four Online Nursing Programs

Here are four CCNE- or ACEN-accredited online nurse practitioner programs:

Here’s a list of four CCNE- or ACEN-accredited online APRN programs:

NP & APRN Certification and Licensing
Licensing

All nurse practitioners must have a registered nursing (RN) license.

Each state board of nursing (SBON) has unique requirements for licensure, but most include:

  • Completing an accredited nursing degree program
  • Passing the NCLEX exam

APRNs must hold current and unencumbered registered nursing (RN) licenses that meet state-level requirements to qualify for an APRN license.

Sample Certifications

Nurse practitioners have many specialized board certifications to choose from, such as:

  • American Academy of Nurse Practitioners Certification Board
  • American Nurses Credentialing Center (ANCC)
  • Pediatric Nursing Certification Board (PNCB)

Many states require licensed APRNs to hold national certification from an organization such as:

  • American Midwifery Certification Board (AMCB)
  • National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA)
Sample Credentials and Recertification

The American Academy of Nurse Practitioners Certification Board, for example, offers three APRN certifications:

  • Adult-Gerontology Primary Care Nurse Practitioner (AGNP)
  • Emergency Nurse Practitioner (ENP)
  • Family Nurse Practitioner (FNP)

These credentials can be renewed every five years with education (CE) and clinical practice hours.

The American Midwifery Certification Board (AMCB) offers this credential to nurse midwife graduate degree holders:

  • Certified Nurse Midwife (CNM)

To recertify, credential holders must complete continuing education and professional development through the organization’s certificate maintenance programs (CMP).

Specializations

NPs have several major specializations to choose from:

  • Acute care nurse practitioner
  • Adult-gerontology nurse practitioner, primary or acute care (AGNP)
  • Pediatric nurse practitioner, primary or acute care (PNP)
  • Family nurse practitioner (FNP)
  • Psychiatric-mental health nurse practitioner (PMHNP)
  • Neonatal nurse practitioner (NNP)
  • Women’s health nurse practitioner (WHNP)

There are also many subspecializations, including:

As previously mentioned, APRNs include four main classifications of nurse practitioners:

  • Nurse practitioner (NP)
  • Certified registered nurse anesthetist (CRNA)
  • Clinical nurse specialist (CNS)
  • Certified nurse-midwife (CNM)

Specializations for APRNs include:

  • Pediatric nurse practitioner
  • Dental certified registered nurse anesthetist
  • Geriatric clinical nurse specialist
Details About the Job
Scope of Practice

The campaign to grant nurse practitioners full practice authority is supported by many professional organizations, including the American Academy of Nurse Practitioners (AANP).

More than half of the US states give NPs full practice authority to practice without the supervision of a physician.

Depending on the state where they live and work, APRNs may or may not have full practice authority. APRNs and NPs in states with full practice authority can evaluate, diagnose, order and interpret diagnostic tests, begin and manage treatments, and prescribe medications without physician supervision.

Nursing Skills Necessary for SuccessFirst and foremost, NPs must have exceptional skills in caring for the healthcare needs of their patients. This includes but is not limited to exceptional communication skills within clinical teams and when relating to patients and their families. Precision and patients are key skills.It’s no surprise that ARPNs must have impeccable abilities to communicate essential health information to their teams and their patients. APRNs in leadership and educational roles must uphold standards of care while leading and educating teams of nurses.
Work Environments

The BLS (May 2021) listed these industries as the highest employers of nurse practitioners:

  • Offices of physicians: 110.490 employed
  • General medical and surgical hospitals: 52,790
  • Outpatient care centers: 22,630
  • Offices of health practitioners: 9,360
  • Home health care services: 6,630

The BLS (2022) shows the top employers of APRNs as follows:

  • Offices of physicians: 47 percent
  • Hospitals; state, local, and private: 25 percent
  • Outpatient care centers: 9 percent
  • Educational services; state, local, and private: 5 percent
  • Offices of other health practitioners: 3 percent
Rachel Drummond

Rachel Drummond

Writer

Rachel Drummond is a freelance writer, educator, and yogini from Oregon. She’s taught English to international university students in the United States and Japan for more than a decade and has a master’s degree in education from the University of Oregon. A dedicated Ashtanga yoga practitioner, Rachel is interested in exploring the nuanced philosophical aspects of contemplative physical practices and how they apply in daily life. She writes about this topic among others on her blog (Instagram: @racheldrummondyoga).