A nurse practitioner (NP) is a registered nurse with a master's or doctoral degree and national board certification who can examine patients, diagnose illnesses, order and interpret tests, and prescribe medication. NPs work in primary care, hospitals, urgent care, mental health and dozens of specialties, and in many states they can run their own practices without a physician's supervision. There are now more than 461,000 licensed NPs in the United States, and they account for nearly 1 billion patient visits every year, according to the American Association of Nurse Practitioners (AANP).
This guide covers everything in one place: what NPs do, how they compare to doctors, physician assistants and registered nurses, the different types of NPs, how long it takes to become one, what they earn, where the role came from, and how to celebrate the NPs in your life during NP Week and beyond.
In this guide
- What is a nurse practitioner?
- What can a nurse practitioner do?
- NP vs doctor vs PA vs RN at a glance
- Is a nurse practitioner the same as a doctor?
- What is the difference between an NP and a PA?
- What is the difference between an RN and an NP?
- DNP vs NP: what is the difference?
- What are the different types of nurse practitioners?
- How long does it take to become a nurse practitioner?
- How much do nurse practitioners make?
- Who created the nurse practitioner role?
- When is National Nurse Practitioner Week?
- How do you celebrate and thank a nurse practitioner?
- A little NP humor
- Frequently asked questions
What is a nurse practitioner?
A nurse practitioner is an advanced practice registered nurse (APRN). Every NP starts as a registered nurse, then completes graduate education (a Master of Science in Nursing or a Doctor of Nursing Practice), passes a national certification exam in a patient population, and earns a state APRN license. The U.S. Bureau of Labor Statistics groups NPs with two other APRN roles: nurse anesthetists and nurse midwives. Curious how nurse anesthetists compare? Read our complete guide to CRNAs.
What does NP stand for? In health care, NP stands for nurse practitioner. You will often see it after a name with a certification, such as "Jane Smith, MSN, FNP-C," where FNP-C means a board-certified family nurse practitioner.
What makes NPs distinct is the combination of clinical medicine and the nursing model of care. NPs are trained to diagnose and treat, but their education also puts heavy weight on prevention, patient education and looking at the whole person, including lifestyle, family and circumstances, not only the symptom in front of them.
What can a nurse practitioner do?
Nurse practitioners can do most of what people expect from a primary care provider. According to the Bureau of Labor Statistics and AANP, NPs typically:
- Take medical histories and perform physical exams
- Order and interpret lab work, X-rays and other diagnostic tests
- Diagnose acute and chronic conditions, from strep throat to diabetes and depression
- Create and manage treatment plans
- Prescribe medications. NPs hold prescriptive privileges, including controlled substances, in all 50 states and Washington, D.C.
- Refer patients to specialists and coordinate care with other providers
- Counsel patients and families on prevention and managing illness
Can nurse practitioners practice on their own?
It depends on the state. AANP sorts every state into one of three practice environments:
- Full practice: NPs can evaluate, diagnose, treat and prescribe under the authority of the state board of nursing, with no required physician agreement. AANP's current count is 27 states, D.C. and two U.S. territories, and the list has grown steadily over the last decade.
- Reduced practice: state law limits at least one element of NP practice and requires a career-long collaborative agreement with another provider.
- Restricted practice: state law requires career-long supervision or team management by another provider, usually a physician.
Because these laws change often, AANP's State Practice Environment map is the best place to check the current rules in any state.
NP vs doctor vs PA vs RN at a glance
These four roles often work side by side, which is why people mix them up. Here is how they compare on training, focus and pay.
| Nurse practitioner (NP) | Physician (MD or DO) | Physician assistant (PA) | Registered nurse (RN) | |
|---|---|---|---|---|
| Degree | MSN or DNP, after becoming an RN | 4-year medical degree | Master's in PA studies (2 to 3 years) | Associate or bachelor's in nursing |
| Post-graduate training | Not required (optional fellowships) | 3 to 7 years of residency | Not required (optional residencies) | Not required |
| Supervised clinical hours in school | 500 minimum (many programs require 750 or more), plus prior RN experience | 12,000 to 16,000 including residency | About 2,000 | Varies by program |
| Training model | Nursing model, focused on one patient population | Medical model, then a specialty | Medical model, generalist | Nursing model |
| Diagnose and prescribe? | Yes | Yes | Yes, with physician collaboration or supervision | No |
| Independent practice? | Yes, in full practice states | Yes | Generally no | No |
| Median pay (BLS, May 2025) | $132,300 | $275,930 | $135,880 | $97,550 |
Sources: U.S. Bureau of Labor Statistics Occupational Outlook Handbook; AANP; American Medical Association (physician and PA training hours); National Organization of Nurse Practitioner Faculties (NP clinical hour minimum).
Is a nurse practitioner the same as a doctor?
No. A nurse practitioner is not a physician. Both can examine, diagnose, treat and prescribe, and for many everyday health needs you may see either one. The difference is in the path and depth of training.
- Training length: physicians complete four years of medical school followed by three to seven years of residency. NPs complete an RN program, usually work as nurses, then complete two to four years of graduate NP education. Residency is optional for NPs.
- Clinical hours: physician training includes roughly 12,000 to 16,000 patient care hours, according to the American Medical Association. NP programs require a minimum of 500 supervised hours, though NP students also bring years of hands-on nursing experience.
- Focus: physicians are trained in the medical model, which centers on disease, and many go on to deep specialization. NPs are trained in the nursing model, with extra emphasis on prevention, education and the whole patient.
- Complex cases: for highly complex, rare or surgical conditions, a physician specialist typically leads care. NPs are trained to recognize when a case needs a referral.
Can you call a nurse practitioner "doctor"?
NPs who earn a Doctor of Nursing Practice (DNP) hold a doctoral degree, so the title "Dr." is academically accurate. In clinical settings, though, many states require that anyone using "Dr." who is not a physician clearly state their role, for example "Dr. Lee, your nurse practitioner." Rules vary by state.
Should I see a nurse practitioner or a doctor?
For checkups, preventive care, common illnesses, and managing ongoing conditions like high blood pressure, asthma or anxiety, an NP is a well-trained choice, and appointments are often easier to get. For complex, unusual or surgical problems, you will likely be referred to a physician specialist. In many practices, NPs and physicians work as one team and consult each other daily.
What is the difference between an NP and a PA?
Nurse practitioners and physician assistants (PAs) are the two most common "advanced practice providers," and their day-to-day work can look almost identical. Both hold graduate degrees, diagnose, treat and prescribe. BLS data even shows nearly identical median pay: $132,300 for NPs and $135,880 for PAs. The differences are in how they are trained and how they practice.
- Background: NPs must be registered nurses first, and most work as nurses before NP school. PAs come from a range of science and health care backgrounds and do not need to be nurses.
- Training model: NPs train in the nursing model and certify in a specific patient population (family, pediatrics, psychiatric mental health and so on). PAs train in the medical model as generalists, completing about 2,000 clinical hours across many specialties.
- Switching specialties: because PAs are trained as generalists, it is often easier for a PA to move from, say, dermatology to orthopedics. An NP changing populations typically needs additional certification.
- Independence: NPs can practice independently in full practice states and can open their own clinics. PAs generally practice in collaboration with or under the supervision of a physician.
- Certification: NPs certify through bodies such as the AANP Certification Board or the American Nurses Credentialing Center. PAs pass the PANCE exam and earn the PA-C credential.
What is the difference between an RN and an NP?
Every NP is an RN, but not every RN is an NP. The NP role is the next step up, with a graduate degree, national certification and a much wider scope of practice.
- Education: RNs need an associate or bachelor's degree in nursing and must pass the NCLEX-RN exam. NPs add a master's or doctorate, national board certification and a state APRN license.
- Scope: RNs assess patients, give medications and treatments that a provider has ordered, monitor patients and educate families. NPs make the diagnosis, order the tests and write the prescriptions.
- Pay: the BLS median for RNs is $97,550, compared with $132,300 for NPs.
Many NPs say their years as an RN are what make them good providers. They have spent thousands of hours at the bedside before ever writing their first prescription.
DNP vs NP: what is the difference?
This one confuses a lot of people because the two terms describe different things. NP is a role and a license. DNP is a degree.
- A nurse practitioner is the clinical job: the certified, licensed provider who sees patients.
- A Doctor of Nursing Practice is the highest practice-focused degree in nursing. It emphasizes leadership, quality improvement and applying research in real clinical settings.
Many NPs are prepared with a master's degree (MSN). Others earn a DNP, either before or after becoming an NP. A DNP-prepared NP sees patients the same way an MSN-prepared NP does, but the doctorate can open doors to leadership, teaching and health policy roles. Not every DNP is an NP, either: some DNPs work in administration or education rather than direct patient care.
What are the different types of nurse practitioners?
NPs certify in a patient population. Family nurse practitioners are by far the largest group, making up nearly 7 in 10 NPs, according to AANP. Here are the main types:
| Type | Credential | Who they care for |
|---|---|---|
| Family nurse practitioner | FNP | Patients of all ages, from newborns to older adults, mostly in primary care |
| Psychiatric mental health NP | PMHNP | Patients across the lifespan with mental health and substance use conditions; can diagnose and prescribe psychiatric medications |
| Adult-gerontology NP (primary or acute care) | AGPCNP / AGACNP | Teens through older adults, in clinics (primary) or hospitals and ICUs (acute) |
| Pediatric NP (primary or acute care) | CPNP-PC / CPNP-AC | Infants, children and teens |
| Women's health NP | WHNP | Gynecologic, reproductive and prenatal care |
| Neonatal NP | NNP | Newborns, often premature or critically ill babies in the NICU |
| Emergency NP | ENP | Patients of all ages in emergency departments and urgent care (a specialty certification, usually added to an FNP) |
Beyond these population certifications, NPs work in almost every specialty you can think of, including dermatology, cardiology, oncology, orthopedics, aesthetics and hospice.
How long does it take to become a nurse practitioner?
Most people need six to eight years from the start of college to their first job as an NP. AANP notes that NPs complete at least six years of undergraduate and graduate education combined. The usual path looks like this:
- Become a registered nurse (2 to 4 years). Earn an associate or, more commonly, a Bachelor of Science in Nursing (BSN) and pass the NCLEX-RN.
- Gain nursing experience (often 1 to 2 years). Many NP programs require or strongly prefer bedside experience, and most NP students keep working as nurses during school.
- Complete an NP program (2 to 4 years). An MSN typically takes two to three years. A BSN-to-DNP program usually takes three to four.
- Pass a national certification exam in your patient population, such as family or psychiatric mental health.
- Get your state APRN license and, if you will prescribe controlled substances, your DEA registration.
There are faster routes for some people. RN-to-MSN bridge programs help associate-degree nurses skip a separate bachelor's, and "direct entry" programs let people with a non-nursing bachelor's degree earn their RN and NP credentials in one longer program.
Is NP school hard?
Yes, and most NPs will tell you so. Graduate courses in advanced pathophysiology, pharmacology and health assessment are demanding, clinical rotations take hundreds of hours, and many students do it all while working as nurses and raising families. That is exactly why graduation and passing boards are milestones worth celebrating.
How much do nurse practitioners make?
The median annual wage for nurse practitioners was $132,300 in May 2025, according to the Bureau of Labor Statistics. The median means half of NPs earned more and half earned less. Among advanced practice nurses, only nurse anesthetists earn more, with a median of $236,590. Learn more in our complete guide to CRNAs. To see where NPs rank among all the nursing specialties, read our guide to the highest paying nursing jobs.
Pay varies with specialty, state, setting and experience. Across the broader APRN group, BLS found median pay was higher in outpatient care centers and hospitals than in physician offices. Psychiatric mental health, acute care and emergency NPs often earn above the median, and pay in large metro areas tends to be higher, though so is the cost of living.
The job outlook is exceptional. BLS projects NP employment will grow 41 percent from 2025 to 2035, from about 336,300 jobs to 474,100. That makes NPs one of the fastest-growing occupations in the country, driven by an aging population, more chronic disease and states expanding NP practice authority.
Who created the nurse practitioner role?
The nurse practitioner role began in 1965 at the University of Colorado, when nurse Dr. Loretta Ford and pediatrician Dr. Henry Silver launched the first NP program. Ford had spent years as a public health nurse in rural Colorado, where doctors were scarce and families, especially children, went without care. She believed nurses could safely do much more if they had advanced training.
That first program trained pediatric nurses, who went on to staff clinics in rural and urban communities with little access to health care. The idea faced real resistance at the time, but it worked, and it spread quickly. Here is how the profession grew:
- 1965: Ford and Silver start the first NP program, focused on pediatrics.
- 1972: Ford becomes the founding dean of the University of Rochester School of Nursing, where she continues to shape advanced nursing education.
- 1970s and 1980s: NP programs multiply across the country, and states begin writing laws that recognize NP practice.
- 2000s onward: more states adopt full practice authority, and the number of NPs climbs past 100,000, then 300,000.
- Today: more than 461,000 licensed NPs practice across the United States.
Dr. Ford lived to see the profession she co-founded become one of the largest in health care. She died on January 22, 2025, at age 104, and she was still consulting and lecturing well into her 100s.
When is National Nurse Practitioner Week?
National Nurse Practitioner Week (NP Week) is celebrated every November. In 2026, it runs from Sunday, November 8, through Saturday, November 14. The week is led by AANP and has two goals: recognizing the care NPs provide, and raising awareness of state laws that limit how NPs can practice.
During NP Week, governors, legislators and city leaders sign official proclamations honoring NPs. In 2025, for the first time, every state and territory submitted a proclamation signed by an elected official.
Is there a Nurse Practitioner Day?
There is no separate national Nurse Practitioner Day. The official celebration is the full NP Week in November. People often confuse it with National Nurses Week, which runs May 6 to 12 each year and honors all nurses, including NPs. So NPs get two chances a year to be celebrated, which is a good excuse to do both.
NP Week ideas for employers and teams
- Post a spotlight on each NP on your practice's social media, with a line about why patients love them.
- Cater a lunch, or better, cover a coffee order every day of the week.
- Add NP Week wishes to your patient newsletter or waiting room screens.
- Fund a continuing education course, a conference registration or a certification renewal.
- Ask your state representatives to sign an NP Week proclamation, using AANP's free resource guide.
- Give the team matching shirts or a small keepsake they will actually use on shift.
How do you celebrate and thank a nurse practitioner?
NP Week is the big one, but it is not the only moment worth marking. These are the milestones NPs remember most:
- NP school graduation after years of juggling classes, clinicals and often a full-time nursing job
- Passing boards, the national certification exam that makes it official
- The first NP job and the first patient panel of their own
- NP Week in November and Nurses Week in May
- Work anniversaries, promotions and finishing a DNP
- The holidays, when many NPs are still covering shifts
What to write in a card for a nurse practitioner
A few sincere words go further than any gift. Use these as they are or as a starting point:
- "Happy NP Week! Thank you for listening, really listening, every single time."
- "You caught what others missed. Thank you for taking such good care of our family."
- "To the best provider on our team: thank you for making every shift better. Happy NP Week!"
- "Congratulations, NP! All those late nights and clinical hours paid off. We are so proud of you."
- "Boards: passed. Title: earned. The world just got a great new nurse practitioner."
- "Thank you for treating us like people, not charts."
Gift ideas for nurse practitioners
The best NP gifts are practical enough to use on a long shift or personal enough to celebrate how hard they worked for the title. A few ideas that consistently land:
- Apparel that shows NP pride, like shirts, sweatshirts and scrub-friendly layers they can wear on days off or casual Fridays.
- Shift essentials such as an insulated tumbler, compression socks, a quality pen set or a stethoscope ID tag.
- Personalized keepsakes with their name and credentials (FNP-C, PMHNP-BC and so on), especially for graduates and new NPs.
- Team gifts for NP Week, like matching shirts for everyone in the practice.
- Experience gifts, such as a massage, a good meal or a paid CE course.
Gifts and apparel for NP Week, graduation, passing boards and every milestone in between.
Shop NP gifts →How to celebrate a new NP graduate
Finishing NP school is one of the biggest days in a nurse's career. A few ways to make it feel as big as it is:
- Throw a small party themed around their new title, with a cake or banner that uses their credentials.
- Give something they will use in their first NP job, like a personalized item with "NP" or their new credential on it.
- Offer a practical gift of time: meals delivered during board prep, or a weekend away after they pass.
- Write a card that names the sacrifices they made. They will remember that longer than any gift.
A little NP humor
NPs spend their days handling serious things, so they appreciate a laugh. A few lines that get knowing nods in any clinic:
- "Yes, I can prescribe that. No, I am not the doctor. Yes, I will still fix it."
- "NP: Nearly Perfect. Nurse Practitioner is just the official title."
- "I survived NP school, clinicals and boards. Your 4:55 p.m. walk-in does not scare me."
- "My handwriting is not bad. It is advanced practice."
- "Powered by coffee, clinical judgment and 500+ hours of clinicals."
Frequently asked questions
What does NP stand for in medical terms?
NP stands for nurse practitioner, an advanced practice registered nurse with a graduate degree and national certification who can diagnose conditions, order tests and prescribe medication.
Can a nurse practitioner be your primary care provider?
Yes. Most NPs work in primary care, and many patients choose an NP as their main provider for checkups, illnesses and chronic conditions. Your insurance plan may list NPs alongside physicians as primary care options.
Can nurse practitioners prescribe controlled substances?
Yes. According to AANP, NPs have prescriptive privileges, including controlled substances, in all 50 states and D.C. Some states add limits or require a collaborative agreement for certain drug schedules.
Do nurse practitioners make more than physician assistants?
Their pay is very close. BLS reports a May 2025 median of $132,300 for NPs and $135,880 for PAs. Specialty, location and setting matter more than the title.
How many years is NP school?
An NP program takes about two to three years for a master's (MSN) or three to four years for a doctorate (DNP), after earning an RN license. From the start of college, most people take six to eight years to become an NP.
Is a nurse practitioner higher than a registered nurse?
Yes. An NP is an advanced practice role that requires an RN license first, plus a graduate degree, national certification and a state APRN license. NPs have a wider scope of practice, including diagnosing and prescribing.
When is Nurse Practitioner Week?
NP Week is held every November. In 2026, it runs from November 8 to 14.
What is a good gift for a nurse practitioner?
Practical shift items (a tumbler, compression socks, a stethoscope tag), NP-themed apparel and personalized keepsakes with their credentials are all popular. For graduates, anything that celebrates the new "NP" title is a winner. You can browse ideas in our nurse practitioner collection.
Celebrate the NP in your life
Graduation, boards, NP Week or just because: find a gift that honors the title they worked so hard for.
Shop the NP Collection →Sources
- U.S. Bureau of Labor Statistics, Occupational Outlook Handbook: Nurse Anesthetists, Nurse Midwives, and Nurse Practitioners
- American Association of Nurse Practitioners, NP Facts
- American Association of Nurse Practitioners, National NP Week
- American Medical Association, Scope of Practice: Education Matters
- University of Colorado College of Nursing, Dr. Loretta Ford