Nurse Practitioner (NP) Practice Authority By State & Scope of Practice

Nurse practitioners (NPs) are graduate-trained professionals who provide high-quality and cost-effective healthcare. They meet the needs of underserved and vulnerable populations, helping the United States to combat its looming primary care shortage. However, their ability to prescribe specific medications and fulfill functions as independent practitioners can be limited by the state in which they live.

Discover how limited and restricted practice laws affect NPs within these states—and how APRNs and advocates are fighting for full practice authority. NPSchools.com has interviewed professors from all of the states with bold outlines on the map. Check out the complete practice authority details for all states in the table below.

AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC

– Full NP Practice State

– Limited NP Practice State

– Restricted NP Practice State

What is NP Practice Authority?

Nurse practitioners are essential physician extenders. They can provide much of the same care and services as physicians, with fewer years of education and often at a much lower cost.  However, many states still restrict the extent to which nurse practitioners can practice and whether or not they must be supervised by a physician. 

For example, a recent interview detailed how New Jersey nurse practitioners must have a Joint Protocol in place to have many practice privileges.  Dr. Mary Ellen Roberts, an associate professor in the College of Nursing at Seton Hall University, stated in the 2021 interview that, “NPs that have started their own practices, and they have this Joint Protocol, they have to pay the physician to be a collaborator. They never see the physician. The physician doesn’t come to their office. But they’re still paying the physician a fee for him to sign this joint protocol. And the fees are oftentimes exorbitant.”

There are numerous organizations currently lobbying state legislatures for full practice authority for nurse practitioners. They include the American Nurses Association, the American Association of Nurse Practitioners, the Veterans Administration, the AARP, the Institute of Medicine, the Federal Trade Commission, and many more. Physician associations such as the American Medical Association often oppose these efforts, arguing that nurses cannot replace fully trained physicians. 

In states with fewer restrictions, nurse practitioners help increase patient access to healthcare and serve in many underserved rural areas. The full practice authority model has been adopted in many states, with many more having a path to full practice authority after a period of supervision. Here are the three general levels of practice authority:

  • Full practice: Laws in these states allow nurse practitioners to practice independently. They have full authority to perform services within the scope of their specialty, including prescribing medications, medical equipment, and treatments. There may be an additional application or continuing education required in order to receive prescriptive authority. 
  • Limited or reduced practice (but can transition to full practice): Some states require nurse practitioners to complete a supervised work experience prior to receiving autonomous practice privileges. The amount of time required varies by state but, upon completing the number of hours required, nurse practitioners may have full independent authority, including prescriptive abilities.  
  • Restricted practice: Nurse practitioners in restricted states will always need physician supervision or a collaborative agreement in order to carry out at least one aspect of their practice. In some states, nurse practitioners may be able to practice independently but need an agreement for prescriptive authority. In other states, there must be an agreement for any care provided beyond the scope of a registered nurse.

Below is a table detailing each state’s regulations regarding practice authority for nurse practitioners. It should be noted that there is pending legislation in several states, thanks to the tireless efforts of advocacy organizations, and this can change at any time. The Covid-19 pandemic has also reshaped the practice environments within some states. Included are links to each state’s nursing board and nurse practice act for the most up-to-date information. 

From the Editor: Please note that some states’ statuses may differ from the popular AANP map. Also, in the wake of the Covid-19 pandemic, some states have expanded practice authority for NPs to assist with healthcare shortages. As always, we encourage readers to reach out with any updates or corrections. Contact us here.

StateBoard of NursingPractice ActPrescriptive AuthorityDetails & Resources
Alabama Alabama Board of Nursing Alabama Board of Nursing Administrative Code Must have a collaborative practice with a supervising physician Must be in a collaborative practice with a supervising physician. Collaborative practice is regulated by the Alabama Board of Medical Examiners.
Alaska Alaska Board of Nursing Alaska Nursing Statutes (article 4) Full practice with current license Must submit a separate application and fee to prescribe Schedule 2-5 controlled substances.
Arizona Arizona Board of Nursing Arizona Nursing Statutes, AZ Nurse Practice Act Full practice with current license and DEA registration Nurse practitioners who prescribe  controlled substances, will need to apply to the Drug Enforcement Administration for a DEA number as well as utilize the Controlled Substance Prescription Monitoring Program (CSPMP)

Arkansas Arkansas Board of Nursing Arkansas Nurse Practice Act Must have a collaborative practice agreement with a supervising physician and proof of completion of a board-approved pharmacology course. 

Nurse practitioners who have completed 6,240 hours of practice under a collaborative agreement may apply for a Full Independent Practice Credential.
Nurse practitioners can only prescribe Schedule 3-5 controlled substances. Schedule 2 substances may be prescribed under limited circumstances and under the supervision of a physician.
California California Board of Registered Nursing CA Nursing Practice Act Beginning in January 2023, nurse practitioners may obtain full practice authority after three years and at least 4,600 hours of practice under supervision.
Nurse practitioners may prescribe Schedule 2-5 controlled substances, under the supervision of a physician, and as long as the practitioner has completed a pharmacology course. They must also have a furnishing number.
Colorado Colorado Board of Nursing Colorado Nurses and Nurse Aides Practice Act Full prescriptive authority with a current license after meeting board requirements Requirements for provisional prescriptive authority include three years of nursing work experience and education in controlled substances and prescriptions. 

Once provisional authority has been granted, NPs must complete 750 hours of mentorship with an advanced practice nurse or physician. When the hours are complete, NPs may prescribe under their own authority.
ConnecticutConnecticut Board of Examiners for NursingConnecticut Nurse Practice ActMust initially have a collaborative practice with a supervising physician, but can transition to full practice after three years For the first three years of holding a license, nurse practitioners must be in collaboration with a physician. Upon completing three years and at least 2,000 hours of supervision, NPs may practice under their own authority.
Delaware Delaware Board of NursingDelaware Nursing Laws Full prescriptive authority with a current license after meeting board requirements Nurse practitioners automatically get prescriptive authority for non-controlled substances with their license.
If they wish to apply for a controlled substance registration, they must submit a  Controlled Substances Registration – Advanced Practice Registered Nurses application.
District of Columbia Washington DC Board of NursingWashington DC Nurse Practice Act Full prescriptive authority with a current license Nurse practitioners are authorized to sign any document that must be signed by a physician. They can prescribe Schedule 2-5 controlled substances.
Florida Florida Board of NursingFlorida Nurse Practice Act Must complete 3,000 hours of collaborative practice and three semester-hours of graduate coursework in the past five years Nurse practitioners are required to maintain professional liability insurance.
Georgia Georgia Board of NursingGeorgia Nurse Practice Act Must have a protocol agreement with a practicing physician Nurse practitioners may not prescribe Schedule 1-2 controlled substances. All prescriptions must be within the scope of the protocol agreement.
HawaiiHawaii Board of NursingHawaii Nursing Statutes (subchapter 14) Full prescriptive authority with a current license and approved prescriptive authority application To be eligible to apply for prescriptive authority, NPs must have a current state license, national certification, a graduate degree, and proof of 30 continuing education hours in pharmacology.
Idaho Idaho Board of Nursing Idaho Nurse Practice ActFull prescriptive authority with a current license Upon completion of 30 hours of continuing education in pharmacology, NPs may prescribe Schedule 2-5 controlled substances.
Illinois Illinois Board of Nursing Illinois Nurse Practice ActMust complete 4,000 hours of clinical experience and 250 hours of continuing education trainingIn order to prescribe Schedule 2 controlled substances or benzodiazepines, NPs must have a collaborative agreement with a physician. They must also obtain an Illinois controlled substance license and a federal Drug Enforcement Administration number.
Indiana Indiana State Board of NursingIndiana Nurse Practice ActMust have a collaborative practice with a supervising physician Nurse practitioners must complete a pharmacology course of at least two semester-hours in the last five years. If more than five years have elapsed, they may complete 30 hours of continuing education.
Iowa Iowa Board of NursingIowa Nurse Practice Act Full prescriptive authority with a current license Nurse practitioners must practice within their specialty area.
Kansas Kansas State Board of NursingKansas Nurse Practice ActIn April 2022, House Bill 2279 was signed into state law, bringing Full Practice Authority to KansasPrescriptions must include the name of the physician. In order to prescribe controlled substances, a nurse practitioner must register with the DEA and notify the nursing board of the name and address of the responsible physician.
Kentucky Kentucky Board of Nursing Kentucky Nurse Practice Act In order to prescribe medications, nurse practitioners must complete four years under a Common Collaborative Agreement with a supervising physicianAfter four years, nurse practitioners may apply to be exempt from a collaborative agreement and have a full independent practice.
LouisianaLouisiana Board of NursingLouisiana Nurse Practice ActMust have a collaborative practice agreement In order to prescribe medications, NPs must have 500 hours of work experience (as NPs) and 45 continuing education hours (or three semester-hours) in pharmacology, advanced health assessment, and advanced physiology.
Maine Maine Board of Nursing Maine Nurse Practice ActFull prescriptive authority after 24 months under supervision The supervision for the 24-month clinical experience can be completed by a physician or a nurse practitioner.
MarylandMaryland Board of NursingMaryland Nurse Practice ActFull prescriptive authority with a current license An NP who has completed their national certification and education program and has applied to the state for licensure may practice under the supervision of a licensed NPs or physicians until their license is approved.
Massachusetts Massachusetts Board of NursingMassachusetts Nursing Statutes After two years of prescribing medications under supervision, nurse practitioners can have independent and full prescriptive authority Any form that must be certified by a physician may be completed by a Certified Nurse Practitioner (CNP).
Michigan Michigan Board of NursingMichigan Public Health Code (1978) Must have physician supervision in order to prescribe Schedule 2-5 controlled substances Both the supervising physician and the nurse practitioner must supply a DEA number and sign a prescription in order to provide Scheduled 2-5 controlled substances.
Minnesota Minnesota Board of NursingMinnesota Nurse Practice ActFull practice after 2,080 hours under collaborative management Once collaborative management hours have been completed, there are no prescription restrictions.
MississippiMississippi Board of NursingMississippi Nursing Practice LawMust have a collaborative agreement with a physician In order to prescribe Schedule 2-5 controlled substances, NPs must complete a Mississippi State Board of Nursing approved educational program.
MissouriMissouri Board of NursingMissouri Nursing Rules & StatutesMust practice under a Collaborative Practice Agreement (CPA) with a supervising physician All prescriptive privileges must be outlined in the CPA. If the CPA specifies it, NPs may prescribe Schedule 2-5 controlled substances
Montana Montana Board of NursingMontana Nurse Practice Act Full authority to practice independently with a current license and an approved prescriptive authority application In order to prescribe medications, NPs must complete an application for prescriptive authority. Application requirements include proof of completed coursework in pharmacology.
NebraskaNebraska Department of Health and Human ServicesNebraska Nursing Regulations & Statutes (including NP Act)Must complete 2,000 hours of clinical practice in a transition-to-practice collaborative agreement In order to prescribe Schedule 2-5 controlled substances, DEA registration is required.
Nevada Nevada Board of NursingNevada Nurse Practice Act Must complete 2,000 hours of clinical practice and submit an approved application from the Nevada Board of Pharmacy Nurse practitioners who wish to prescribe controlled substances must also register with the DEA.
New Hampshire New Hampshire Board of NursingNew Hampshire Nurse Practice ActFull practice authority with a current license There are no additional requirements to prescribe controlled substances.
New Jersey New Jersey Board of NursingNew Jersey Board of Nursing Law Must have a joint protocol with a supervising physician to have prescriptive authority The joint protocol agreement must outline how, when, and why prescriptions may be issued as well as whether or not the NP may prescribe controlled substances.
New Mexico New Mexico Board of NursingNew Mexico Nurse Practice ActFull practice authority with a current license Nurse practitioners who prescribe Schedule 2-5 controlled substances must register with the DEA.
New York New York Board of NursingNew York Nurse Rules & RegulationsAfter completing 3,600 hours of clinical practice, an NP may apply for a full independent practice Nurse practitioners who prescribe Schedule 2-5 controlled substances must register with the DEA.
North Carolina North Carolina Board of Nursing, NC 
Medical Board
North Carolina Nurse Practice Act Must have a collaborative agreement with a supervising physician The collaborative agreement must outline the scope of practice. The NP and physician must be available to each other at all times.
North Dakota North Dakota Board of NursingNorth Dakota Nurse Practice Act Full authority to practice independently with a current license and an approved perspective authority applicationTo be eligible for prescriptive authority, nurse practitioners must complete 30 hours of pharmacology continuing education. Nurse practitioners must utilize the North Dakota Prescription Drug Monitoring Program.
Ohio Ohio Board of NursingOH Board of Nursing Laws & Rules Must practice in collaboration with a supervising physicianThe prescriptive authority of an NP is limited by the authority of the supervising physician. Nurse practitioners may only prescribe Schedule 2 controlled substances in limited circumstances.
Oklahoma Oklahoma Board of Nursing Oklahoma Nurse Practice ActMust practice in collaboration with a supervising physician Nurse practitioners must complete 45 hours of pharmacology education.
OregonOregon Board of Nursing Oregon Nursing Rules & Procedures Full authority to practice independently with a current license and an approved prescriptive authority application Nurse practitioners who wish to have prescriptive authority must submit an application and complete 45 hours of pharmacology education.
Pennsylvania Pennsylvania Board of NursingPennsylvania Code of NursingMust practice under a collaborative agreement with a supervising physician Nurse practitioners must register with the DEA in order to dispense controlled substances.
Rhode Island Rhode Island Department of Health Nursing Licensing Rhode Island Nursing Rules & RegulationsFull prescriptive authority Nurse practitioners many only prescribe within their population focus
South Carolina South Carolina Board of NursingSouth Carolina Nurse Practice ActMust have a practice agreement with a collaborative physician In order to receive prescriptive authority, nurse practitioners must complete 45 hours of continuing education in pharmacology, of which 15 hours must be in controlled substances. 

If listed on the practice agreement, nurse practitioners may provide Schedule 2 controlled substances. Otherwise, they are limited to Schedule 3-5.

South Dakota South Dakota Board of Nursing South Dakota Laws & Regulations Must complete 1,400 hours of clinical practice to get prescriptive privileges There are no additional requirements to prescribe controlled substances.
Tennessee Tennessee Board of NursingTennessee Nursing Statutes Must be under the supervision of a physician who has “control and responsibility for
prescriptive services rendered by the nurse”
Nurse practitioners are required to register with the DEA for prescribing controlled substances and must maintain a practitioner profile with the Board of Nursing.
Texas Texas Board of Nursing Texas Nursing Practice ActMust have a protocol or written authorization from a  physician Prescriptive authority for nurse practitioners must be outlined in a prescriptive authority agreement with a supervising physician.
Utah Utah Board of Nursing Utah Nurse Practice Act Must have at least 2,000 hours of clinical experience     In order to prescribe Schedule 2 controlled substances, NPs must have at least 2,000 hours of clinical experience.
Vermont Vermont State Board of NursingVermont Nursing Statutes Full independent practice with a current licenseThere are no additional requirements for full practice authority.
VirginiaVirginia Board of Nursing Virginia Nursing Laws & RegulationsMust have five years of clinical practice under the supervision of a physician to qualify for Autonomous Practice Licensure (APL) If an NP has not met the requirements for independent practice, they must have a practice agreement with a supervising physician in order to prescribe Schedule 2-5 controlled substances.
Washington Washington State Nursing CommissionWashington Nursing Care Laws Full privilege with current license With commission approval, can prescribe legend drugs and schedule 2-5 controlled substances.
West Virginia West Virginia RN Board West Virginia Nursing Code Must have three years in a collaborative practice agreement In order to prescribe medications, even in collaborative practice, NPs must complete 45 hours of education in pharmacology. Schedule 2 drug prescriptions are limited to a 3-day supply.
Wisconsin Wisconsin Board of NursingWisconsin Nursing Laws & Regulations Must have a collaborative practice with a supervising physician Nurse practitioners may only prescribe Schedule 2-5 controlled substances within areas of competence defined by education, training, or experience, and in collaboration with a supervising physician.
Wyoming Wyoming State Board of NursingWyoming Nurse Practice Act
Full privilege with current license Must complete three hours of continuing education on substance use disorders in order to prescribe Schedule 2-5 controlled substances.
Kimmy Gustafson

Kimmy Gustafson

Writer

Among her many diverse writing endeavors, Kimmy Gustafson has also lent her expertise to NPSchools.com since 2020, providing insightful and engaging content about the significant role of education in shaping our future generations of nurse practitioners. Many of her pieces include interviewing experts on timely topics such as healthcare workplace violence and moral distress.

Kimmy has been a freelance writer for more than a decade, writing hundreds of articles on a wide variety of topics such as startups, nonprofits, healthcare, kiteboarding, the outdoors, and higher education. She is passionate about seeing the world and has traveled to over 27 countries. She holds a bachelor’s degree in journalism from the University of Oregon. When not working, she can be found outdoors, parenting, kiteboarding, or cooking.