Your Complete Guide to a Nurse Practitioner (NP) Career

Discover what it takes to become a Nurse Practitioner, from education and certification to salary expectations and job outlook. Whether you’re exploring career options or ready to advance your nursing journey, this comprehensive guide will help you take the next step with clarity and confidence. 

Learn how to advance your nursing career with in-depth insights into the Nurse Practitioner role, education, specialties, salaries, and more.

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What Does a Nurse Practitioner Do?

Thinking about becoming a Nurse Practitioner (NP)? Get the key details on training, certification, and what you can earn in this essential healthcare role.

2 to 6 years

Takes a Long Time to become a NP

$115,800 per year

The average salary of a NP

What Is a Nurse Practitioner (NP)?

Nurse Practitioners (NPs) are highly trained Advanced Practice Registered Nurses (APRNs) who offer a wide range of healthcare services. Depending on the state they practice in, their level of independence can vary, some NPs run their own clinics, while others work in collaboration with physicians. No matter the setting, NPs enjoy a broader scope of practice, increased autonomy, and a more competitive salary compared to traditional registered nurses (RNs).

  • Average Salary: $115,800 per year

  • Time to Become an NP: Typically 2 to 6 years, depending on the path taken

What Do Nurse Practitioners Do?

Nurse Practitioners provide patient-centered care across various specialties. Their day-to-day duties are influenced by their specialty and workplace but generally include:

  • Diagnosing and managing acute and chronic health issues
  • Writing prescriptions and monitoring medication effectiveness
  • Reviewing patient histories and documenting symptoms
  • Ordering and interpreting diagnostic tests
  • Responding to sudden health changes and modifying care plans
  • Performing physical exams and routine health checks
  • Educating patients and their families about preventive care and disease management
  • Collaborating with physicians and interdisciplinary teams

Scope of Practice by State

NP autonomy is governed by state-specific regulations:

  • Full Practice States (e.g., Colorado, Arizona, Washington) allow NPs to work independently.

  • Reduced Practice States (e.g., New York, Illinois, Ohio) require partial physician involvement.

  • Restricted Practice States (e.g., California, Texas, Georgia) mandate significant physician oversight.

Note: NPs can prescribe medications in all 50 states, but only 49 allow prescribing controlled substances.

Educational Requirements and Specialties

At a minimum, Nurse Practitioners must hold a Master’s Degree in Nursing (MSN) and certification in their chosen area of focus. Most NP programs also require some prior nursing experience.

Common NP Specialties:

  • Family Practice
  • Pediatrics
  • Women’s Health
  • Psychiatric-Mental Health
  • Adult-Gerontology
  • Neonatal

NPs may further focus their practice by pursuing subspecialties like:

  • Cardiology
  • Orthopedics
  • Pain Management
  • Sports Medicine
  • Allergy & Immunology
  • Occupational & Environmental Health

Steps to Becoming a Nurse Practitioner

Pursuing a career as an NP involves both academic and professional commitment. Here’s a step-by-step roadmap:

1. Become a Registered Nurse (RN)

Start with a Bachelor of Science in Nursing (BSN) or an Associate Degree in Nursing (ADN). Then, pass the NCLEX-RN to obtain your RN license. While you can become an RN with an ADN, most graduate programs prefer or require a BSN.

Tip: If you have an ADN, consider an accelerated RN-to-BSN program.

2. Gain Clinical Experience

Many graduate programs require at least 1–2 years of RN experience. This also gives you the chance to explore different areas of care before choosing a specialty.

3. Enroll in a Graduate Program

You’ll need either an MSN or a Doctor of Nursing Practice (DNP). MSNs are typically geared toward clinical care, while DNPs often prepare nurses for leadership or academic roles.

Program Requirements May Include:

  • Active RN license
  • Clinical experience
  • Minimum GPA
  • Letters of recommendation
  • GRE scores (some programs)
  • Statement of purpose
  • For those with an ADN, RN-to-MSN or ADN-to-MSN programs are available to fast-track your education.
4. Earn NP Certification

After graduation, you must pass a national certification exam specific to your specialty area. You’ll then apply for licensure through your state’s Board of Nursing. Requirements can vary, so be sure to verify local regulations.

Transitioning from RN to NP

Many RNs aim to become NPs to gain more authority, income, and impact in their roles. Thankfully, there are flexible bridge programs to help RNs advance, regardless of their current level of education.

RN to NP Bridge Options

  1. ADN to NP: For associate degree nurses with at least one year of experience. Includes a bridge year to cover BSN-level content. Duration: ~3–4 years.

  2. Diploma RN to NP: Requires additional coursework. Consult school counselors to ensure eligibility.

  3. BSN to NP: The most direct route. Students start MSN studies right after earning a BSN. Duration: ~2 years.

  4. Non-nursing MSN to NP: Involves accelerated coursework, NCLEX-RN prep, and then NP-specific training. Schools often recommend gaining clinical experience in between.

Financing Your Nurse Practitioner Education

Advanced degrees in nursing can be costly, but there are several ways to manage tuition and other educational expenses.

Employer Tuition Reimbursement

Some hospitals and clinics offer tuition assistance for employees pursuing advanced degrees. Check with your HR department.

Scholarships

Many scholarships don’t require repayment. They can be based on merit, background, volunteer work, or other criteria. Explore:

  • FAFSA for federal opportunities
  • Private scholarship databases (verify the source’s credibility)

Grants

Need-based and repayment-free, grants can help cover tuition, supplies, housing, and more. Graduate-level grants are less common but still available via FAFSA.

Student Loans

While loans are the most common aid option, they must be repaid—with interest.

  • Federal Loans: Lower interest rates, better terms

    • Grad students usually get unsubsidized loans (interest accrues while in school)

  • Private Loans: Offered by banks or institutions; often higher interest

    • Compare offers and read the fine print carefully

Loan Repayment Options

  • Standard Plan: Fixed monthly payments
  • Graduated Plan: Lower payments that increase over time

Most federal loans allow for deferment during graduate school or hardship periods.

Loan Forgiveness Programs

  • Public Service Loan Forgiveness (PSLF): Forgives the balance after 120 qualifying payments while working for eligible nonprofit or government employers
  • Hospital-Based Forgiveness: Some community hospitals offer repayment help after years of service
  • Military Programs: The F. Edward Hébert HPSP and GI Bill Top-Up cover substantial education costs in exchange for service

Top 10 Highest-Paying NP Specialties

While general NP practice is rewarding, some specializations offer particularly strong earning potential. Salaries below are based on available data (as of March 2022) and may vary over time and by location.

Nurse Practitioners can choose from a wide range of specialties, each offering unique roles and earning potential.

Family Nurse Practitioners (FNPs) typically earn around $105,898 annually,

while Psychiatric-Mental Health NPs command salaries ranging from $112,452 to $119,702. Those in the aesthetics field,

like Aesthetic Nurse Practitioners, earn approximately $100,377 per year.

Pediatric NPs often see average annual earnings of $121,659,

and Emergency NPs make around $118,094.

Acute Care NPs average about $110,076,

while Orthopedic NPs bring in approximately $100,035.

Women’s Health NPs see a wider salary range from $96,480 to $130,094,

and Adult-Gerontology NPs typically earn between $89,521 and $117,577.

Among the highest earners are Neonatal Nurse Practitioners, who average $129,309,

and Oncology Nurse Practitioners, with annual salaries around $105,427.

Each specialty reflects both the level of expertise required and the specific demands of the role.

Nurse Practitioner (NP) vs Physician Assistant (PA)

At first glance, Nurse Practitioners and Physician Assistants appear to have similar roles, they both diagnose, treat, and prescribe medications, often with the ability to practice independently (depending on the state). But dig a little deeper, and some key distinctions emerge in their training, philosophy, and job focus. If you’re a nurse planning your next step, understanding how these two paths differ can help you align your decision with your long-term goals.

While both NPs and PAs can perform many of the same clinical tasks, like ordering tests, creating treatment plans, and prescribing medication, their care philosophies differ.

  • Nurse Practitioners follow a nursing model. Their approach is patient-centered and holistic, placing strong emphasis on health education, lifestyle counseling, and disease prevention. NPs often focus on specific patient groups, such as children, women, or those with mental health needs.

  • Physician Assistants, on the other hand, are trained under a medical model, more closely aligned with physicians. They’re geared toward diagnosing and treating illness with a focus on pathology and clinical disease management. PAs often gravitate toward specialties like surgery, emergency medicine, or orthopedics.

In short, NPs prioritize comprehensive, long-term wellness; PAs lean more into medical diagnostics and treatment.

  • Both career paths require graduate-level education, typically taking 2–3 years after earning a bachelor’s degree. That said, there are a few differences to keep in mind:

    • Degree Type:

      • NPs pursue a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP).

      • PAs earn a Master of Physician Assistant Studies or similar.

    • Program Cost:

      • NP programs generally cost $35,000–$70,000, partly because many allow online coursework.

      • PA programs are typically $60,000–$90,000, with most coursework done in person.

    • Continuing Education:

      • NPs must renew their license every 1–2 years, complete 1,000 clinical hours, and meet ongoing CE (continuing education) requirements.

      • PAs must complete 100 CE hours every two years, and pass a recertification exam every 10 years.

    So while the time commitment is similar, the delivery and renewal requirements differ significantly.

Both NPs and PAs have access to diverse job settings, though their specialties may steer them toward different environments.

Where NPs Commonly Work:

  • Private practices or NP-led clinics
  • Hospitals and acute care settings
  • Outpatient care centers
  • Community and government health programs
  • Long-term care or hospice facilities
  • Universities or research institutions
  • Telehealth or triage centers
  • Patient homes (home healthcare)

Where PAs Typically Work:

  • Physician offices or hospital departments
  • Emergency rooms and urgent care centers
  • Surgical units and operating rooms
  • Orthopedic or dermatology clinics
  • Psychiatric hospitals
  • University research labs
  • Government health departments
  • Rural and underserved healthcare areas

While there’s significant overlap, PAs are more commonly found in procedural and surgical settings, while NPs dominate in primary and preventative care.

The earning potential for both roles is strong, but varies based on specialization, location, and experience.

  • According to 2020 data:

    • NPs had a median salary of $111,680

    • PAs earned slightly more, at $115,390

However, these numbers don’t tell the whole story. Entry-level salaries can differ widely:

  • Lowest 10%: NPs ($84,120) earned more than PAs ($76,700)

  • Top 10%: NPs ($190,900) outpaced PAs ($162,740)

And in terms of job growth:

  • NPs are projected to grow 45% from 2020–2030 (~29,400 openings annually)

  • PAs are expected to grow 31% in the same timeframe (~12,200 openings per year)

In short, both careers are in high demand, but NPs may have the edge in future job openings and top-tier salary potential.

Which Path Is Right for You?

It really depends on your career vision:

  • Prefer holistic care, patient education, and long-term wellness? Go the NP route.

  • More interested in clinical procedures, diagnostics, and fast-paced medical environments? PA might suit you better.

Either way, both are meaningful, high-paying, and fast-growing roles in today’s healthcare landscape.

MSN vs DNP: Choosing Your NP Education Path

Once you decide to become a Nurse Practitioner, another big question arises: Should you pursue a Master of Science in Nursing (MSN) or go all-in with a Doctor of Nursing Practice (DNP)?

While both degrees can lead to NP licensure, they come with different timelines, costs, and career trajectories. Here’s a breakdown to help you decide.

How long it takes to complete your NP degree depends on your current education level and whether you’re studying full- or part-time.

MSN Timeline:

  • ADN to MSN: 3–5 years
  • BSN to MSN: 2 years (full-time) or 3–4 years (part-time)

DNP Timeline:

  • ADN to DNP: 5–6 years
  • BSN to DNP: 3–4 years
  • MSN to DNP: 2 years

If you already have an MSN, the DNP can be a natural next step, some nurses even move directly from MSN graduation to DNP enrollment. In total, moving from ADN to DNP can take nearly a decade, though accelerated or bridge programs can shorten that timeline.

Pro tip: Some employers, especially hospitals or academic institutions, offer tuition reimbursement for DNP studies. If this option is available, it could make a significant financial difference.

MSN Practitioners:

  • Must renew certification every 1 to 5 years, depending on specialty and state.

DNP Practitioners:

  • Renew every 5 years

  • Choose between retaking the certification exam or completing:

    • 1,000 clinical hours, or

    • 75 CE units

While both require ongoing learning, DNPs generally have more flexibility in how they maintain their credentials.

Yes, but not always by much, and it depends heavily on role and region.

  • DNP Median Salary: ~$107,000

  • MSN Median Salary: ~$98,000

That $9,000 difference might not sound dramatic, but in leadership or academic roles, DNPs can earn significantly more. For example, a DNP serving as a Chief Nursing Officer may earn far more than an MSN working as a nurse educator.

Bottom line: The DNP can boost your income, especially if you pursue roles beyond clinical care.

MSN Nurse Practitioners:

  • Focus on providing direct patient care

  • Diagnose, treat, and manage patients in primary or specialty care

  • Often work in hospitals, clinics, or private practice

DNP Nurse Practitioners:

  • Trained for clinical care and leadership roles

  • Work in healthcare policy, education, research, and systems improvement

  • Use evidence-based practices to improve patient outcomes on a broader scale

According to the American Association of Colleges of Nursing (AACN), DNPs are especially valuable as the healthcare system becomes more complex and demands more advanced leadership and decision-making.

Where They Work

MSN NPs Commonly Work In:

  • Hospitals
  • Physician offices
  • Community clinics
  • Long-term care facilities
  • Educational institutions

DNPs Often Work In:

  • University systems
  • Healthcare administration
  • Government and policy-making agencies
  • Executive hospital leadership
  • Independent practices
  • While both can practice clinically, DNPs are more likely to find themselves in positions of influence, shaping healthcare systems from the top down.

Final Thoughts: Should You Choose an MSN or DNP?

In 2004, the AACN recommended that all advanced nursing programs eventually transition to the DNP model. While that shift hasn’t been fully realized, the trend is clear: DNP degrees are becoming more popular, and some employers are beginning to require them for advanced roles.

That doesn’t mean an MSN is outdated, far from it. For nurses who want to focus purely on patient care and become an NP as efficiently as possible, the MSN remains a solid choice. But if you want to position yourself for future leadership, teaching, or system-level change, a DNP could be your best bet.

Regardless of which path you choose, one thing is clear: advanced education in nursing will continue to open doors, for your career, your patients, and the future of healthcare.