How Does Nurse Practitioner Authority Vary By State?

The ability of nurse practitioners to work to the full extent of their training and education is an issue which affects NPs nationwide. As documented in recent interviews with some of Michigan’s nurse practitioners and researchers, the fight for full practice authority (FPA) is crucial to help meet the growing demand for qualified providers (particularly in rural areas) and to keep costs down with safe, effective healthcare services. While the VA, the AARP, the FTC, the Institute of Medicine, the Bipartisan Policy Center and many others advocate for granting FPA to NPs, many physician organizations still oppose these efforts. As Dr. Denise Hershey of Michigan State University stated in her 2017 interview, “The biggest challenge in this fight is getting the physician groups to understand that we are not in competition with them; as NPs, we are members of a healthcare team, which includes our physician colleagues and other healthcare professionals the patient may need. As a team, we need to work collaboratively in order to improve the health of our patients.”

The first step toward granting NPs full authority nationwide is to understand the current state practice environments. The American Association of Nurse Practitioners (AANP 2017) broadly defines three practice authority statuses nationwide:

It’s important to note that due to the tireless efforts of NP legislative advocacy, the state practice environments are continually evolving and great efforts will be made to keep this information up-to-date. This table examines the status of NP practice authority across US states, including information about Prescriptive Authority:, links to local boards of nursing and Practice Act:s, and other details.