A nurse practitioner (NP) is a nurse with a graduate degree in advanced practice nursing.

The NP is allowed to provide a broad range of health care services, which may include:

• Taking the patient's history, performing a physical exam, and ordering appropriate laboratory tests and procedures
• Diagnosing, treating, and managing acute and chronic diseases
• Providing prescriptions and coordinating referrals
• Promoting healthy activities in collaboration with the patient
• Performing certain procedures such as a bone marrow biopsy or lumbar puncture

Nurse practitioner work in a variety of settings, including family practice, women's health, pediatrics, geriatric, neonatology, school health, emergency, oncology, cardiology, nephrology, and primary care.

Some nurse practitioners work in clinics without doctor supervision, and others work together with doctors as a joint health care team. Their scope of practice and authority depends on state laws. For example, some states allow nurse practitioners to write prescriptions, while other states do not.

Like many other professions, nurse practitioners are regulated at two different levels. Licensure is a process that takes place at the state level in accordance with specific state laws. In contrast, certification is established through national organizations with requirements for minimal professional practice standards being consistent across all states.

LICENSURE

Laws specific to NP licensure vary greatly from state to state. The current trend is in the direction of more states requiring master's degree educational preparation and national certification. In some states, NP practice is completely independent, while some states require proof of a collaborative MD only for prescriptive practice privileges, and other states require proof of a collaborative MD for licensure at all. A few states still do not have specific nurse practitioner licensure or recognize practice by NPs.

CERTIFICATION

National certification is offered through various nursing organizations (such as the American Nurses' Association, Pediatric Nursing Certification Board, and others), most of which require completion of an approved master's-level NP program prior to taking the certification exam. The exams tend to be offered in specialty areas such as family nursing, pediatrics, school nursing, adult nursing, women's health care, acute care, and geriatrics.

Re-certification involves proof of continuing education. Only certified nurse practitioners may use a "C" either in front of or behind their other credentials (e.g., Certified Pediatric Nurse Practitioner, FNP-C, Certified Family Nurse Practitioner). Some nurse practitioners may use the credential APN rather than NP, denoting advanced practice nurse, a broader category that also includes clinical nurse specialists, certified nurse midwives, and nurse anesthetists.