NP Scope of Practice by State

Alabama requires NPs to practice under a collaborative practice agreement with a physician. For NPs with less than two years (4,000 hours) of collaborative practice experience since initial certification or in the collaborating physician's specialty, the collaborating physician or an approved covering physician must be present for at least 10 percent of scheduled hours, although certain settings and limited protocols are exempt.

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NPs in Alaska can practice independently, including prescribing controlled substances, without physician oversight.

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Arizona grants full practice authority to NPs. After certification by the Board of Nursing, they can diagnose and treat patients, and prescribe once the Board grants prescribing and dispensing authority, all without physician supervision, a collaborative agreement or a transition period.

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Arkansas NPs need a collaborative practice agreement, typically with a physician, to prescribe unless they hold a certificate of full independent practice authority. An NP can apply for that certificate after 6,240 hours of practice under an agreement with a physician or with prescriptive authority in another jurisdiction.

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California NPs generally practice under standardized procedures developed collaboratively with physicians and furnish drugs and devices under physician supervision. NPs who complete a transition to practice in California of three full-time equivalent years or 4,600 hours can be certified to practice without standardized procedures in a group setting with a physician, and usually after at least three more years in good standing, in an independent setting.

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Colorado NPs can practice independently and prescribe medications, including controlled substances. NPs new to prescribing first receive provisional prescriptive authority and must complete a 750 hour prescribing mentorship with a physician or an advanced practice registered nurse who has full prescriptive authority within three years to earn full prescriptive authority.

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Connecticut requires NPs to practice in collaboration with a physician for at least three years and 2,000 hours before practicing independently. After meeting that requirement, an NP must give written notice to the Department of Public Health before practicing without a collaborative agreement.

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Delaware grants full practice and prescriptive authority to NPs when the Board of Nursing issues their advanced practice registered nurse license, and state law requires no collaborative agreement or supervised experience period after licensure.

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Washington, D.C. grants full practice authority to NPs.

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Florida requires NPs to practice under a supervisory protocol with a physician. Since 2020, NPs who meet eligibility requirements may register for autonomous practice limited to primary care, including family medicine, general pediatrics, and general internal medicine; the requirements include, within the preceding five years, at least 3,000 supervised hours of clinical practice and graduate-level coursework, or the equivalent, in differential diagnosis and pharmacology.

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Georgia requires NPs to practice under physician supervision with a protocol agreement.

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Hawaii NPs can practice independently with full prescriptive authority.

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Idaho grants full practice authority to NPs.

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Illinois requires NPs to have a written collaborative agreement until they obtain full practice authority, except when they practice under clinical privileges in a hospital, hospital affiliate or ambulatory surgical treatment center. Full practice authority requires a notarized attestation of at least 4,000 hours of clinical experience after first attaining national certification and at least 250 hours of continuing education or training.

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Indiana NPs must practice under a collaborative agreement with a physician.

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Iowa NPs have independent practice and prescriptive authority.

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Kansas NPs have full independent practice authority.

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Kentucky NPs need a collaborative agreement with a physician to prescribe, with separate agreements for nonscheduled legend drugs and for controlled substances. Once NPs have four years of prescribing experience, which can include prescribing in another state, they may prescribe without these agreements, though dropping the controlled substance agreement first requires a Board of Nursing good standing review.

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Louisiana NPs must have a collaborative practice agreement.

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Maine NPs may prescribe from licensure, including controlled substances in schedules II through V, but must practice for at least 24 months under the supervision of a licensed physician or a supervising NP, or be employed by a clinic or hospital whose medical director is a licensed physician, before practicing independently. A 2026 law replaces this requirement once the Board of Nursing adopts new practice standards by rule, so confirm the current requirement with the Board.

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Maryland grants full practice authority to NPs. Applicants who have never been certified as NPs by any board of nursing must name a mentor on their application, a physician or NP licensed in Maryland with at least three years of clinical practice experience, who is available for consultation and collaboration for 18 months starting on the date the Maryland Board of Nursing receives the application.

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Massachusetts grants full practice authority to NPs once they attest to the Board of Registration in Nursing that they have completed at least two years of supervised practice; until then, a qualified healthcare professional, who may be a physician or an experienced NP, supervises their prescribing. NPs applying by reciprocity who have at least two years of NP practice outside Massachusetts, independent or supervised, may instead prescribe without supervision once they attest to that experience.

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Michigan NPs may prescribe nonscheduled prescription drugs on their own authority, but may prescribe controlled substances in schedules 2 to 5 only as a delegated act of a physician under the physician's written authorization.

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Minnesota NPs must first practice at least 2,080 hours under a collaborative agreement with a physician or with an advanced practice registered nurse who has at least three years of practice, and NPs who provide services other than primary care or mental health services must complete those hours in a setting where advanced practice registered nurses and physicians work together. After that, they may practice independently.

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Mississippi requires NPs to have a collaborative practice agreement.

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Missouri requires NPs to have a collaborative practice arrangement with physician supervision.

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Montana grants full practice authority to NPs.

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Nebraska NPs have full practice authority after a transition period.

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Nevada grants full practice authority to NPs, but until they have at least 2 years or 2,000 hours of clinical experience they may prescribe Schedule II controlled substances only under a protocol approved by a collaborating physician. NPs who completed their program more than 2 years before applying and have never held an APRN license must complete 1,000 hours of supervised practice without prescribing.

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New Hampshire NPs can practice independently.

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New Jersey generally requires NPs to have joint protocols with a collaborating physician in order to prescribe or order medications and devices. Under a 2026 law, NPs in a qualifying population focus with more than 5,000 hours of advanced practice who provide primary or behavioral health care, and do not provide general obstetrics or elective aesthetic or cosmetic services, may practice and prescribe without a joint protocol.

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New Mexico grants full practice authority to NPs.

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NPs in New York with 3,600 hours of practice or fewer must practice in collaboration with a physician under a written practice agreement and written practice protocols. NPs with more than 3,600 hours of practice are currently exempt from those requirements.

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North Carolina requires NPs to practice under physician supervision.

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North Dakota NPs have independent practice authority.

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Ohio NPs must have a standard care arrangement with a collaborating physician.

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Oklahoma NPs who prescribe must have a written supervision agreement with a supervising physician until the Board of Nursing grants them independent prescriptive authority. NPs who have completed 6,240 clinical practice hours with prescriptive authority supervised by a physician may apply for that independent authority.

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Oregon grants full practice authority to NPs.

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Pennsylvania requires a collaborative agreement for NP practice.

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Rhode Island NPs can practice independently.

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South Carolina NPs must perform medical acts under a practice agreement with a physician, who must be readily available for consultation.

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South Dakota NPs need a written collaborative agreement with a physician, certified nurse practitioner or certified nurse midwife licensed in South Dakota until they have completed 1,040 hours of licensed practice. After that, they can practice without a collaborative agreement.

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Tennessee requires physician supervision for NPs.

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Texas requires NPs to have a prescriptive authority agreement with a supervising physician.

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Utah grants full practice authority to NPs.

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Vermont NPs have independent practice authority once they complete the transition to practice. Until they have 24 months and 2,400 hours of licensed active advanced nursing practice in their role and population focus, they must have a collaborative provider agreement with a Vermont licensed physician or advanced practice registered nurse and may not engage in solo practice.

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Virginia NPs must maintain a practice agreement documenting collaboration and consultation with a patient care team physician. An NP with the equivalent of at least three years of full-time clinical experience can apply for a license designation to practice without a practice agreement.

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Washington grants full practice authority to NPs.

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West Virginia NPs must have a collaborative agreement with a physician to prescribe unless the Board of Registered Nurses has approved removal of that requirement. An NP may apply for removal after at least three years of practice in a documented collaborative relationship with prescriptive authority.

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Wisconsin NPs must practice in collaboration with a physician or dentist until the Board of Nursing verifies that they qualify for independent practice. Qualifying requires, among other things, 3,840 clinical hours in their role while working with a physician or dentist and at least 24 months since they began that practice.

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Wyoming NPs can practice independently.

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