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 laboratory tests and procedures
• Diagnosing, treating, and managing diseases
• Providing prescriptions and coordinating referrals
• Promoting healthy activities together with the patient
• Performing certain procedures, such as a bone marrow biopsy or lumbar puncture

Nurse practitioners work in a variety of settings, including:

• Cardiology
• Emergency
• Family practice
• Geriatrics
• Neonatology
• Nephrology
• Oncology
• Pediatrics
• Primary care
• School health
• Women's health

Some nurse practitioners work in clinics without doctor supervision. 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. They are licensed through a process that takes place at the state level under state laws. They are certified through national organizations, with consistent professional practice standards across all states.

LICENSURE

The laws on NP licensure vary greatly from state to state. Today, more states are requiring NPs to have a master's degree and national certification.

In some states, NP practice is completely independent. Other states require that NPs work with an MD for prescriptive practice privileges or to get licensed. A few states still do not have specific nurse practitioner licenses 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 these organizations require that NPs complete an approved master's-level NP program before taking the certification exam. The exams tend to be offered in specialty areas, such as:

• Acute care
• Adult nursing
• Family nursing
• Geriatrics
• Pediatrics
• School nursing
• Women's health care

To be re-certified, NPs need to show 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. This indicates an advanced practice nurse -- a broader category that also includes clinical nurse specialists, certified nurse midwives, and nurse anesthetists.