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 a physician must supervise them. 

For example, a recent interview detailed how Kentucky nurse practitioners must have a collaborative agreement in place to have many practice privileges.  Specifically, they must have a Collaborative Agreement Prescriptive Authority for Controlled Substances (CAPA-CS) and a Collaborative Agreement Prescriptive Authority for Non-Scheduled Drugs (CAPA-NS) to presecribe medications. Dr. Angela Wood, clinical faculty and FNP program coordinator at Eastern Kentucky University School of Nursing stated in the 2024 interview that “It’s a compromise. We were ultimately looking to eliminate the CAPA-CS altogether. But for NPs who’ve been in practice for a long time, this is still a big barrier that’s been removed. For new NPs, there’s some oversight where they must demonstrate safe prescribing practices. It’s a baby step in the right direction.”

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. However, an additional application or continuing education may be required 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 before receiving autonomous practice privileges. The amount of time required varies by state, but upon completing the required hours, 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 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
AlabamaAlabama Board of NursingAlabama Board of Nursing Administrative CodeMust have a collaborative practice with a supervising physicianMust be in a collaborative practice with a supervising physician. Collaborative practice is regulated by the Alabama Board of Medical Examiners.
AlaskaAlaska Board of NursingAlaska Nursing Statutes (article 4)Full practice with current licenseMust submit a separate application and fee to prescribe Schedule 2-5 controlled substances.
ArizonaArizona Board of NursingArizona Nursing Statutes, AZ Nurse Practice ActFull practice with current license and DEA registrationNurse 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)
ArkansasArkansas Board of NursingArkansas Nurse Practice ActMust 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. 
CaliforniaCalifornia Board of Registered NursingCA Nursing Practice ActNurse practitioners must be under the supervision of a physician when they first start their practice. 

Nurse practitioners may obtain full practice authority after three years and at least 4,600 hours of practice under supervision. This law went into effect in 2023 so the first NPs who can apply for this independent authority can do so in 2026. 
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. 
ColoradoColorado Board of NursingColorado Nurses and Nurse Aides Practice ActFull prescriptive authority with a current license after meeting board requirementsRequirements 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 yearsFor 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. 
DelawareDelaware Board of NursingDelaware Nursing LawsFull prescriptive authority with a current license after meeting board requirementsNurse 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 ColumbiaWashington DC Board of NursingWashington DC Nurse Practice ActFull prescriptive authority with a current licenseNurse practitioners are authorized to sign any document that must be signed by a physician. They can prescribe Schedule 2-5 controlled substances.
FloridaFlorida Board of NursingFlorida Nurse Practice ActMust 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.
GeorgiaGeorgia Board of NursingGeorgia Nurse Practice ActMust 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. 
IdahoIdaho Board of NursingIdaho Nurse Practice ActFull prescriptive authority with a current license Upon completing 30 hours of continuing education in pharmacology, NPs may prescribe Schedule 2-5 controlled substances. 
IllinoisIllinois Board of NursingIllinois Nurse Practice ActMust complete 4,000 hours of clinical experience and 250 hours of continuing education trainingTo 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.
IndianaIndiana State Board of NursingIndiana Nurse Practice ActMust have a collaborative practice with a supervising physicianNurse 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. 
IowaIowa Board of NursingIowa Nurse Practice ActFull prescriptive authority with a current license Nurse practitioners must practice within their specialty area. 
KansasKansas 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. 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. 
KentuckyKentucky Board of NursingKentucky Nurse Practice ActTo prescribe medications, nurse practitioners must complete four years under a Common Collaborative Agreement with a supervising physician After four years, nurse practitioners may apply to be exempt from a collaborative agreement and have a fully independent practice. 
LouisianaLouisiana Board of NursingLouisiana Nurse Practice ActMust have a collaborative practice agreement 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. 
MaineMaine Board of NursingMaine Nurse Practice ActFull prescriptive authority after 24 months under supervisionThe 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 NP or physician until their license is approved.
MassachusettsMassachusetts Board of NursingMassachusetts Nursing StatutesAfter two years of prescribing medications under supervision, nurse practitioners can have independent and full prescriptive authorityAny form that must be certified by a physician may be completed by a Certified Nurse Practitioner (CNP).
MichiganMichigan Board of Nursing Michigan Public Health Code (1978)Must have physician supervision in order to prescribe Schedule 2-5 controlled substancesBoth 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. 
MinnesotaMinnesota Board of NursingMinnesota Nurse Practice ActFull practice after 2,080 hours under collaborative managementOnce collaborative management hours have been completed, there are no prescription restrictions.
Mississippi Mississippi Board of NursingMississippi Nursing Practice LawMust have a collaborative agreement with a physicianIn 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 physicianAll prescriptive privileges must be outlined in the CPA. If the CPA specifies it, NPs may prescribe Schedule 2-5 controlled substances
MontanaMontana Board of NursingMontana Nurse Practice ActFull 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 ActMust complete 2,000 hours of clinical practice and submit an approved application from the Nevada Board of PharmacyNurse practitioners who wish to prescribe controlled substances must also register with the DEA. 
New HampshireNew Hampshire Board of Nursing New Hampshire Nurse Practice ActFull practice authority with a current licenseThere are no additional requirements to prescribe controlled substances. 
New JerseyNew Jersey Board of NursingNew Jersey Board of Nursing LawMust have a joint protocol with a supervising physician to have prescriptive authorityThe 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 MexicoNew Mexico Board of NursingNew Mexico Nurse Practice ActFull practice authority with a current licenseNurse practitioners who prescribe Schedule 2-5 controlled substances must register with the DEA.
New YorkNew York Board of NursingNew York Nurse Rules & RegulationsAfter completing 3,600 hours of clinical practice, an NP may apply for a full independent practiceNurse practitioners who prescribe Schedule 2-5 controlled substances must register with the DEA.
North CarolinaNorth Carolina Board of Nursing, NC  Medical BoardNorth Carolina Nurse Practice ActMust 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 DakotaNorth Dakota Board of NursingNorth Dakota Nurse Practice ActFull authority to practice independently with a current license and an approved perspective authority application To 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.
OhioOhio Board of NursingOH Board of Nursing Laws & RulesMust 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. 
OklahomaOklahoma Board of NursingOklahoma Nurse Practice ActMust practice in collaboration with a supervising physicianNurse practitioners must complete 45 hours of pharmacology education.
OregonOregon Board of NursingOregon Nursing Rules & ProceduresFull 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. 
PennsylvaniaPennsylvania Board of NursingPennsylvania Code of NursingMust practice under a collaborative agreement with a supervising physicianNurse practitioners must register with the DEA in order to dispense controlled substances.
Rhode IslandRhode Island Department of Health Nursing LicensingRhode Island Nursing Rules & RegulationsFull prescriptive authorityNurse practitioners may only prescribe within their population focus 
South CarolinaSouth Carolina Board of NursingSouth Carolina Nurse Practice ActMust have a practice agreement with a collaborative physicianTo 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 DakotaSouth Dakota Board of NursingSouth Dakota Laws & RegulationsMust complete 1,400 hours of clinical practice to get prescriptive privileges There are no additional requirements to prescribe controlled substances.
TennesseeTennessee Board of NursingTennessee Nursing StatutesMust 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. 
TexasTexas Board of NursingTexas 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.
UtahUtah Board of NursingUtah Nurse Practice Act Full independent practice with a current license There are no additional requirements for full practice authority.
VermontVermont State Board of NursingVermont Nursing StatutesFull independent practice with a current license There are no additional requirements for full practice authority.
VirginiaVirginia Board of NursingVirginia 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 to prescribe Schedule 2-5 controlled substances. 
WashingtonWashington State Nursing CommissionWashington Nursing Care LawsFull privilege with current licenseWith commission approval, can prescribe legend drugs and schedule 2-5 controlled substances.
West VirginiaWest Virginia RN BoardWest Virginia Nursing CodeMust have three years in a collaborative practice agreementIn 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.
WisconsinWisconsin Board of NursingWisconsin Nursing Laws & RegulationsMust have a collaborative practice with a supervising physicianNurse 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.
WyomingWyoming State Board of NursingWyoming Nurse Practice Act
Full privilege with current licenseMust 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.