What Is a Nurse Practitioner?

Medically Reviewed by Zilpah Sheikh, MD on April 25, 2024
Written by Marijke Vroomen Durning, RN, Amy Gopal
8 min read

A nurse practitioner (NP) is a health care professional who offers a wide range of acute, primary, and specialty care services, either alone or alongside a doctor.

The services a nurse practitioner can provide depend on the state in which they practice. In many states, NPs are licensed to be fully independent practitioners who can prescribe medications and do certain procedures without supervision by a doctor.

As primary care doctors leave the profession faster than they can be replaced, especially in rural areas, nurse practitioners can play a larger role as primary care providers. They’re also vital to care in specialized medicine, which has its own shortages of doctors.

Is a nurse practitioner a doctor?

A nurse practitioner is not a medical doctor, although some NPs may have a doctorate degree.

Licensing can vary state by state, and there can be a lot of overlap in the roles of NPs and doctors, but nurse practitioners focus on preventing diseases and promoting the health and well-being of the whole person.

These are just some of the tasks that NPs may perform:

  • Provide wellness care, including education on healthy living and disease prevention, and counseling
  • Perform physical exams and take medical histories
  • Order and interpret/analyze blood tests and other lab tests and X-rays
  • Diagnose and treat illnesses and conditions. They can also manage infections and injuries.
  • Provide long-term care for chronic diseases
  • Prescribe medications and treatments
  • Provide referrals for specialist care

Nurse practitioner work environment

NPs may work in hospitals, private doctors' offices, telehealth programs, other health care facilities, and schools.

Nurse practitioners have a wide scope of practice, although they may be allowed to do more things in certain states. In some states, nurse practitioners can set up their own clinic or office and treat patients without a doctor’s supervision. In others, they can diagnose and treat short-term (acute) and long-term (chronic) problems in a doctor’s office and other outpatient settings under a doctor’s supervision. 

There are three levels of nurse practitioner practice:

  • Full practice: NPs may have their own offices and can practice independently of doctors.
  • Reduced practice: NPs may practice along with another health care professional or with certain limitations.
  • Restricted practice: NPs may practice but only under supervision of another health care professional. 

All nurse practitioners must be registered nurses and have completed a Bachelor of Science in Nursing (BSN) program, followed by a Master of Science in Nursing (MSN) in the nursing practitioner track, or Doctor of Nursing Practice (DNP) degree. NPs then pass a standardized exam to get certification from the specialty nursing board that oversees their practice area.

Finally, NPs must get a license from their state. The requirements vary and may include renewing a license or completing a certain number of continuing education hours each year.

In order to become a nurse practitioner, you must first be a registered nurse (RN). Many nurses start off their career with an associate's degree and then continue their education. Or you can become an RN along with your BSN. Once you have your BSN, you will need your MSN with the nurse practitioner specialty. However, many master’s programs require that you have a certain number of clinical hours – time you have worked as a nurse – before they will accept you into an MSN program.

How much does a nurse practitioner earn in the United States?

A nurse practitioner salary varies greatly across the country. The states that pay the most have an annual mean wage of $132,000 to $162,000. Those include:

  • California
  • Nevada
  • Washington
  • New Jersey
  • Oregon

The ones that pay the least, with an annual mean wage ranging from $88,000 to $121,000, are:

  • Alabama
  • Arkansas
  • Florida
  • Kansas
  • Kentucky
  • Louisiana
  • Michigan
  • Missouri
  • Montana
  • South Carolina
  • Tennessee
  • West Virginia

Just like there are different types of medical doctors, there are different types of NPs. 

Acute care nurse practitioners (ACNP) 

Acute care nurse practitioners (ACNP) work in hospitals or acute care clinics. They see patients when they are sick, are admitted to the hospital, have injuries, or have surgical procedures. They treat patients from admission to discharge.

They can order diagnostic and laboratory tests to help diagnose diseases. They may do procedures such as intubation, debriding wounds, and putting casts on injuries. They work as part of a health care team to develop a treatment plan and follow-up care.  

Family Nurse Practitioner (FNP)

Nearly 70% of nurse practitioners are primary care nurse practitioners, also known as family nurse practitioners (FNP). Much like family doctors, family or general nurse practitioners provide primary care by doing wellness and physical exams, managing treatment plans, and educating patients. 

In order to practice as an FNP, you must pass an FNP certification exam, which covers topics that can affect people from birth to older age.

Adult-gerontology nurse practitioner (AGNP)

Adult-gerontology nurse practitioners, AGNPs, work with people from their teen years to late adulthood. Their expertise in geriatrics makes them a valuable resource to help aging adults to stay well and manage illnesses. AGNPs can focus on primary care, as do FNPs, or they can work in acute care, which includes the emergency department or intensive care unit, and other similar settings. All AGNPs must pass their specialty’s licensing exam.

Pediatric nurse practitioner (PNP)

A pediatric nurse practitioner, PNP, focuses on children ranging from birth to age 18. They work as general nurse practitioners do, focusing on child health and wellness. They can do physical exams and health screenings. They can also manage or treat non-acute illnesses.

Some PNPs work in acute care settings, like AGNPs. These are PNP-ACs. All PNPs must pass their specialty’s licensing exam, and if they want to be a PNP-AC, there is a separate certification.

Neonatal nurse practitioners (NNP)

Neonatal nurse practitioners, NNPs, are even more specialized than PNPs because they work with high-risk infants who were either premature or born with a health problem or congenital disorder. NNPs can work in acute care, in the neonatal intensive care unit (NICU), and also in the delivery room and emergency department. NNPs aren’t only in acute settings though. Some NNPs follow patients after they have been discharged from the hospital if needed, and their patients see them until they are 2 years old. All NNPs must pass their specialty’s licensing exam.

Women’s health nurse practitioner (WHNP)

Nurse practitioners can specialize in women’s health if they have the WHNP training. They help women with gynecological care in hospitals, fertility clinics, OB/GYN offices, and private practices. All WHNPs must pass their specialty’s licensing exam.

Psychiatric nurse practitioner (PMHNP)

Psychiatric nurse practitioners, PMHNPs, are mental health professionals. They can diagnose and treat, including with prescription medications, people living with mental illnesses, including substance abuse problems. PMHNPs may work alone or with a psychiatrist (MD). Like other nurse practitioners, they can work in a wide variety of health care settings. All PMHNPs must pass their specialty’s licensing exam.

Other areas where you might find a nurse practitioner

There are many areas in health care where a nurse practitioner can work, so you could come across an oncology nurse practitioner or an orthopedic  nurse practitioner, among others. And NPs don‘t have to stay in one specialty for their whole career. They may choose to go back to school to complete a certification in another specialty. For example, a pediatric nurse practitioner may be interested in working with high-risk infants and can get a neonatal nurse practitioner certification.

Medical doctors have a longer and more vigorous training program than nurse practitioners. This allows them to cover a larger scope of practice. NPs don’t have as extensive training, but their education and clinical learning is specialized in the area that interests them, like women’s health or pediatrics. 

Nurse practitioners are a valuable part of the health care team. Many times, nurse practitioners work in collaboration with doctors, so you may see either one when you visit their office. You may also choose to see a nurse practitioner instead of a doctor. These appointments might be easier to schedule and be less expensive.

Nurse practitioners may provide treatment that is focused more on the whole patient, since their training emphasizes improved health and disease prevention rather than just disease treatment.

Nurse practitioners are registered nurses who have at least a master’s degree with a nurse practitioner emphasis and must be certified in each state in which they want to practice. They're an important part of the health care team, providing care to patients in many types of settings and in the community. NPs can specialize in various areas of medicine, including in acute care. In many states, NPs can set up private practices, while in others, they must be supervised by a medical doctor.

What's the difference between a nurse and a nurse practitioner?

A nurse is a health care professional who has studied nursing. After graduation, nurses take licensing exams to practice in their state. They're limited to what they can do as outlined by their licensing body. A nurse practitioner is a nurse who has obtained a master’s degree in nursing, specializing in being a nurse practitioner, or a Doctor of Nursing Practice (DNP) degree. A nurse practitioner must be a nurse, but a nurse isn't necessarily a nurse practitioner.

Is a nurse practitioner the same as a doctor?

No, a medical doctor has many more years of education than a nurse practitioner does and has a much wider scope of practice.

What are the duties of a nurse practitioner?

A nurse practitioner can do many things that doctors can do, including wellness care and education, physical exams, ordering and interpreting lab tests, making diagnoses, and treating many illnesses or conditions.

What's the difference between a nurse practitioner and a physician assistant?

Nursing practitioners and physician assistants, or PAs (now called physician associates), are both part of a health care team. Both NPs and PAs must have at least a master’s degree in their field to practice their profession. NPs started their careers as nurses, but you don't need to have a health background to enter a PA program if you meet the educational requirements. 

Both professions have many of the same tasks and responsibilities, but NPs generally have more ability to specialize than PAs. PAs must also work under a doctor’s supervision and can't have a private practice.