Committed to the Success of Nurse Practitioners

State Licensure and Certification: Myths and Realities

by Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC

YOU ARE COMPLETING your nurse practitioner education, likely one of the most challenging tasks you have ever undertaken. Now, NP certification and licensure loom in your future. You probably have spoken to a number of certified and practicing NPs about these issues. Much of the information they share is helpful. However, there is also a good deal of inaccurate information circulating. Here are some common myths and realities about these important subjects.

Myth: Once I am nationally certified, I am also licensed to practice as an NP.
Reality: In nearly all states, achievement of national certification is one of a number of requirements to obtain a license as a nurse practitioner. NP licensure is handled at the state level through the board of nursing. Information about the NP practice act in your state can be obtained by contacting your state board of nursing. Links to all of these state agencies can be found at http://www.ncsbn.org.

Myth: Once I am a certified NP and licensed to practice in one state, I will be able to practice in every state.
Reality: NP licensure is handled at the state level, and regulations vary from state to state. As a result, you must meet the requirements for, and obtain a license in, every state in which you practice.

Myth: From state to state, NP practice acts are quite similar.
Reality: State NP practice acts differ significantly in a number of ways. For example, in some states, an NP must have a physician collaborator to obtain prescriptive authority. Other states do not have this requirement, and NPs are able to prescribe without any physician oversight. In certain states, state law mandates third-party reimbursement to NPs (this rate of reimbursement can vary significantly). While NPs have the authority to prescribe controlled substances in all but one state (Florida), the prescriptions permitted range from schedules II through V in some states to III through V only in others. Make sure you are aware of the scope of NP practice and particulars of the NP practice act in each state in which you are licensed.

Myth: My state doesn’t require national certification to get an NP license, so I don’t need to take the NP boards.
Reality: Only three states allow NPs to practice without certification: California, Kansas, and New York. The days of practicing without certification are likely numbered because virtually all third-party insurers and NP employers require certification. The result is that many non-certified NPs are now seeking the same documentation of professional achievement as the nation’s certified NPs.

Not having NP certification is quite professionally limiting. Without certification, moving from state to state and continuing to practice can be difficult or impossible. In addition, since most employers require certification, changing jobs can be challenging.

Revised 10.7.13.