[hen-ui-dynamic-experience placement=”aboveTheFold” /][hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″]The 10-year job growth projection for nurse practitioners (NPs) is 40%, much faster than the average growth for all occupations.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Twenty-nine states have full-practice authority where nurse practitioners can open their practice.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]NPs who want to open their practice must consider many factors and plan to protect their personal and professional assets.[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-text variant=”b4″]Federal 10-year projections estimate that job growth for [hen-ui-link href=”https://nursejournal.org/careers/advanced-practice-nursing/”]advanced practice registered nurses (APRNs)[/hen-ui-link], a classification that includes [hen-ui-link href=”https://nursejournal.org/nurse-practitioner/”]nurse practitioners (NPs)[/hen-ui-link], will dramatically outpace other occupations.[/hen-ui-text][hen-ui-text variant=”b4″]The Bureau of Labor Statistics (BLS) projects that NP jobs will grow a whopping 40% from 2032 to 2033. By comparison, all U.S. occupations combined are slated to grow an average of 3% a year.[/hen-ui-text][hen-ui-text variant=”b4″]The demand for NPs is fueled largely by the ongoing nursing and physician shortages — the U.S. is predicted to face an [hen-ui-link href=”https://www.aamc.org/news/press-releases/new-aamc-report-shows-continuing-projected-physician-shortage” target=”_blank”]86,000 physician shortage by 2036[/hen-ui-link]. This creates a need not for more healthcare providers overall, including NPs who are authorized to work independently. Additionally, an aging population and the burden of chronic conditions are further straining the delivery system.[/hen-ui-text][hen-ui-text variant=”b4″]NPs who work in [hen-ui-link href=”https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/”]full-practice authority states[/hen-ui-link] can offer patients a greater range of services and options than doctors.[/hen-ui-text][hen-ui-text variant=”b4″]Learn more about the NP practice authority in each state, how to advocate for full-practice authority, and what to consider before opening your practice.[/hen-ui-text][hen-ui-flex gap=”xl” align=”left” direction=”column”][hen-ui-flex gap=”xs” align=”left” direction=”column”][hen-ui-heading variant=”h2″]Popular Online MSN Programs[/hen-ui-heading][hen-ui-text variant=”b4″ color=”subtext”]Learn about start dates, transferring credits, availability of financial aid, and more by contacting the universities below.[/hen-ui-text][/hen-ui-flex][hen-ui-dynamic-experience placement=”belowTheFold” /][/hen-ui-flex][hen-ui-heading variant=”h2″]Nurse Practitioner Scope of Practice[/hen-ui-heading][hen-ui-text variant=”b4″]The American Nurses Association (ANA) defines the nursing scope of practice as the “services that a qualified health professional is deemed competent to perform, and permitted to undertake — in keeping with the terms of their professional license.”[/hen-ui-text][hen-ui-text variant=”b4″]The advanced training NPs receive allows them to service communities by working within their scope of practice. In broad terms, an NP’s scope of practice includes:[/hen-ui-text][hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″]Patient assessment[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Ordering diagnostic tests[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Interpreting laboratory results[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Patient treatment[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Diagnosing patients[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-text variant=”b4″]Medical procedures such as performing surgeries are strictly performed by physicians.[/hen-ui-text][hen-ui-text variant=”b4″]The American Association of Nurse Practitioners (AANP) identifies three types of practice regulations for NPs that define the scope of practice NPs have within state regulations. These three types are:[/hen-ui-text][hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″][hen-ui-text tag=”strong” weight=”bold”]Full-practice authority:[/hen-ui-text] Under full-practice laws, an NP can prescribe, diagnose, and treat patients without physician oversight or supervision. NPs in these states can practice independently, including operating their practice.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″][hen-ui-text tag=”strong” weight=”bold”]Reduced-practice authority:[/hen-ui-text] An NP can diagnose and treat patients but requires physician oversight to prescribe medications.[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″][hen-ui-text tag=”strong” weight=”bold”]Restricted-practice authority:[/hen-ui-text] An NP must have physician supervision or oversight to prescribe, diagnose, and treat patients.[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-text variant=”b4″]The practice regulations are legal and legislative [hen-ui-link href=”https://pubmed.ncbi.nlm.nih.gov/32384361/” target=”_blank”]restrictions on practice authority[/hen-ui-link]. In other words, data demonstrate that NPs offer excellent primary and specialty care, whether it is offered under physician oversight or independently.[/hen-ui-text][hen-ui-heading variant=”h2″]Nurse Practitioner Authority by State[/hen-ui-heading][hen-ui-text variant=”b4″]There are 29 [hen-ui-link href=”https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/”]full-practice authority states for NPs[/hen-ui-link], including the District of Columbia, 11 reduced-practice authority states, and 10 restricted-practice authority states.[/hen-ui-text][hen-ui-text variant=”b4″]If you’re looking to open your practice, it’s important to know the details of your practice authority in each state, including any recent or potential changes. You can do this by checking with your [hen-ui-link href=”https://nursejournal.org/resources/what-is-the-role-of-the-state-board-of-nursing/”]state board of nursing[/hen-ui-link].[/hen-ui-text][hen-ui-text variant=”b4″]As an example of the potential complexity of these laws, the state of Florida became a full-practice state in 2020. However, NPs are granted an “autonomous” license when they meet certain criteria.[/hen-ui-text][hen-ui-text variant=”b4″]To work independently, an NP must:[/hen-ui-text][hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″]Complete 3,000 hours under a physician’s oversight[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Have an active and unencumbered registered nurse license[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Provide proof of graduate-level classes in differential diagnosis and clinical pharmacology[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Have no disciplinary action within the last five years[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-heading variant=”h2″]11 Factors to Consider When Opening Your Own Practice[/hen-ui-heading][hen-ui-text variant=”b4″]Although NPs can practice independently in many states, there is limited data on the number of NPs who open an independent practice.[/hen-ui-text][hen-ui-text variant=”b4″]Navigating information on how to open your primary care practice as an NP can be confusing. You may be unsure where to begin.[/hen-ui-text][hen-ui-text variant=”b4″]Here are 11 factors to consider.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Understand Your “Why”[/hen-ui-heading][hen-ui-text variant=”b4″]When the going gets tough, and it will, remembering why you are opening your practice can help you meet challenges head-on. This clarity can make it easier to resolve yourself to the hard work ahead.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Know the Law[/hen-ui-heading][hen-ui-text variant=”b4″]State laws vary on the type of practice you may open. Additionally, you must be current on business law and the required licenses and permits to open a practice. Consider working with a healthcare or business attorney familiar with NP practices.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Apply for a National Provider Identifier[/hen-ui-heading][hen-ui-text variant=”b4″]As a licensed and certified NP, you should already have your unique[hen-ui-link href=”https://www.cms.gov/Regulations-and-Guidance/Administrative-Simplification/NationalProvIdentStand” target=”_blank”] National Provider Identifier[/hen-ui-link] (NPI) number. Providers must use their NPI number in administrative and financial transactions adopted under the Health Insurance Portability and Accountability Act (HIPAA). You will need your NPI to bill Medicare and access health records.[/hen-ui-text][hen-ui-text variant=”b4″]Your business may also need a unique NPI number to practice in your state.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Insurance[/hen-ui-heading][hen-ui-text variant=”b4″]You’ll need [hen-ui-link href=”https://nursejournal.org/ask-a-nurse/do-i-need-personal-liability-insurance/”]malpractice insurance for an independent healthcare provider[/hen-ui-link] and business insurance to protect your assets. You may want to consider cyber insurance to protect your practice against the consequences of hacking.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Credentialing[/hen-ui-heading][hen-ui-text variant=”b4″]NPs must be credentialed with specific insurance companies to bill insurance companies for their services. The credentialing process may take a few months, so start before you open your practice. Contact individual insurance providers to find out their credentialing process.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Cash Flow and Billing[/hen-ui-heading][hen-ui-text variant=”b4″]As an NP and business owner, you must determine if you are taking private and governmental insurance like Medicare and Medicaid. You can also decide if your practice will be self-pay/cash only.[/hen-ui-text][hen-ui-text variant=”b4″]Consider the billing and payment software you’ll use. Will you outsource billing initially or hire someone? Since expenses likely outsource income for at least six months, you may want to consider having a part-time job until the practice is profitable.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]A Business Plan[/hen-ui-heading][hen-ui-text variant=”b4″]A business plan will help you organize how you want your business to run. It will also address your financial requirements before opening your private practice. For example, you need office space, furniture, equipment, an office assistant, a website, and a marketing budget. It is important to create a business plan before opening your practice. Contact your local small business association (SBA) for help in starting your business.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Leverage Social Media[/hen-ui-heading][hen-ui-text variant=”b4″]Join entrepreneur groups and [hen-ui-link href=”https://nursejournal.org/resources/networking-in-nursing/”]network with other NPs and healthcare professionals[/hen-ui-link]. You’ll be surprised at how much you can learn.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Marketing[/hen-ui-heading][hen-ui-text variant=”b4″]Marketing your practice may feel foreign to you, but how can you provide care if no one knows you’re in business? Network with people in your area and tell them about your practice and what makes it unique. Consider these marketing options to spread the word about your practice:[/hen-ui-text][hen-ui-list variant=”unordered” bullet-style=”bullet”] [hen-ui-list-item][hen-ui-text variant=”b4″]YouTube or Tik-Tok videos[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Social media accounts[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Putting an ad in the local news outlet[/hen-ui-text][/hen-ui-list-item] [hen-ui-list-item][hen-ui-text variant=”b4″]Creating a LinkedIn page[/hen-ui-text][/hen-ui-list-item][/hen-ui-list][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Infrastructure[/hen-ui-heading][hen-ui-text variant=”b4″]As you develop your business, remember that you’ll need a [hen-ui-link href=”https://nursejournal.org/healthcare/medical-billing-and-coding/medical-billing-and-coding-vs-nursing/”]medical biller and coder[/hen-ui-link], an accountant, and an attorney. You’ll also want to find reliable medical suppliers. Internal processes and procedures are equally important. How will you gather and share medical information? Will you e-prescribe or use a paper-based service? These are just a few questions to consider.[/hen-ui-text][hen-ui-heading variant=”h3″ class=”text-secondary-700″]Mentor[/hen-ui-heading][hen-ui-text variant=”b4″]Look through your contacts and seek a mentor. Having a mentor can help you understand your business better, avoid common pitfalls, and help you bounce ideas for your business.[/hen-ui-text][hen-ui-heading variant=”h2″]Frequently Asked Questions About Nurse Practitioner Practices[/hen-ui-heading][hen-ui-accordion variant=”no-background”] [hen-ui-accordion-item title=”What does full-practice NP mean?” expanded=”true”] [hen-ui-text variant=”b4″]In essence, full-practice authority for nurse practitioners means that NPs have the legal right to practice to the full extent of their training, meaning they can evaluate, diagnose, and treat patients (including by prescribing medications) independently and without a physician’s supervision.[/hen-ui-text] [/hen-ui-accordion-item] [hen-ui-accordion-item title=”Why can NPs practice independently but not PAs?”] [hen-ui-text variant=”b4″]NPs can practice autonomously in many states but collaborate with physicians in others. Physician assistants, or PAs, are trained to work under and alongside physicians. Still, they can prescribe medications without restrictions.[/hen-ui-text] [/hen-ui-accordion-item] [hen-ui-accordion-item title=”In which states can NPs practice independently?”] [hen-ui-text-stack gap=”sm”] [hen-ui-text variant=”b4″]Check our [hen-ui-link href=”https://nursejournal.org/nurse-practitioner/np-practice-authority-by-state/”]state-by-state NP practice guide[/hen-ui-link] for more details, but as of 2024, the U.S. states and territories that allow NPs to practice independently include Alaska, Arizona, Colorado, Connecticut, Delaware, District of Columbia, Guam, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Northern Mariana Islands, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, and Wyoming.[/hen-ui-text] [/hen-ui-text-stack] [/hen-ui-accordion-item] [hen-ui-accordion-item title=”What is NP in medical terms?”] [hen-ui-text variant=”b4″]A nurse practitioner has advanced training and is a type of advanced practice registered nurse (APRN). NPs are highly trained healthcare professionals who provide high-quality care to various patients with relatively simple and complex conditions.[/hen-ui-text] [/hen-ui-accordion-item][/hen-ui-accordion]