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Updated September 2026 - AANP data

NP Scope of Practice by State: Full, Reduced & Restricted (2026)

Quick answer

Nurse practitioner scope of practice is set state by state and falls into three tiers defined by AANP and NCSBN: full practice (NPs evaluate, diagnose, treat, and prescribe - including controlled substances - under the exclusive licensure authority of the state board of nursing, no physician agreement required), reduced practice (a career-long collaborative agreement with a physician, or a setting limit, is required for at least one element of care), and restricted practice (career-long physician supervision, delegation, or team management is required). As of the 2026 AANP practice environment map, 27 states plus Washington, DC have full practice authority; the rest are reduced or restricted.

The three NP practice authority tiers

AANP, NCSBN, and the National Academy of Medicine classify every state's NP practice environment into one of three tiers. This page uses the same framework - not a different one - applied to all 50 states plus Washington, DC.

Full Practice Authority

NPs evaluate, diagnose, order and interpret tests, and initiate and manage treatment - including prescribing controlled substances - under the exclusive licensure authority of the state board of nursing. No career-long collaborative agreement with a physician is required.

Reduced Practice

State law reduces an NP's ability to perform at least one element of practice - typically a career-long regulated collaborative agreement with a physician, or a limit on the setting where an element of care can happen.

Restricted Practice

State law restricts an NP's ability to perform at least one element of practice and requires career-long supervision, delegation, or team management by another health provider.

Per AANP's 2026 map: 28 full practice jurisdictions (incl. DC), 12 reduced practice, 11 restricted practice.

NP practice authority by state - all 50 states + DC

Search by state name, or filter by tier. Every row links to the state's official board of nursing.

Alabama

Reduced Practice

Collaborative practice agreement with a physician required to diagnose and treat

Alabama Board of Nursing

Alaska

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Alaska Board of Nursing

Arizona

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Arizona Board of Nursing

Arkansas

Reduced Practice

Collaborative practice agreement required for full scope of practice

Arkansas Board of Nursing

California

Restricted Practice

Most NPs practice under standardized procedures approved by a supervising physician

California Board of Nursing

Colorado

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Colorado Board of Nursing

Connecticut

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Connecticut Board of Nursing

Delaware

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Delaware Board of Nursing

District of Columbia

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

District of Columbia Board of Nursing

Florida

Restricted Practice

Autonomous practice (HB 607, 2020) is limited to family medicine, general pediatrics, general internal medicine, and certified nurse-midwifery, after 3,000 supervised hours

Florida Board of Nursing

Georgia

Restricted Practice

Nurse protocol agreement with a supervising physician required for diagnosis and treatment

Georgia Board of Nursing

Hawaii

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Hawaii Board of Nursing

Idaho

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Idaho Board of Nursing

Illinois

Reduced Practice

Reduced practice by default - a career-long collaborative agreement is required unless an NP separately qualifies for Full Practice Authority (APRN-FPA)

Illinois Board of Nursing

Indiana

Reduced Practice

Collaborative agreement with a physician required for prescriptive authority

Indiana Board of Nursing

Iowa

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Iowa Board of Nursing

Kansas

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Kansas Board of Nursing

Kentucky

Reduced Practice

Collaborative agreement with a physician required for at least one element of practice, most often prescribing

Kentucky Board of Nursing

Louisiana

Reduced Practice

Collaborative practice agreement with a physician required

Louisiana Board of Nursing

Maine

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Maine Board of Nursing

Maryland

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Maryland Board of Nursing

Massachusetts

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Massachusetts Board of Nursing

Michigan

Restricted Practice

Participating physician relationship required for prescriptive authority

Michigan Board of Nursing

Minnesota

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Minnesota Board of Nursing

Mississippi

Reduced Practice

Collaborative/consultation agreement with a physician required

Mississippi Board of Nursing

Missouri

Restricted Practice

Collaborative practice arrangement with a supervising physician required, including geographic-proximity rules

Missouri Board of Nursing

Montana

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Montana Board of Nursing

Nebraska

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Nebraska Board of Nursing

Nevada

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Nevada Board of Nursing

New Hampshire

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

New Hampshire Board of Nursing

New Jersey

Reduced Practice

Joint protocol with a physician required for controlled-substance prescribing

New Jersey Board of Nursing

New Mexico

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

New Mexico Board of Nursing

New York

Full Practice Authority

Full practice authority (2023)

New York Board of Nursing

North Carolina

Restricted Practice

Supervision agreement required

North Carolina Board of Nursing

North Dakota

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

North Dakota Board of Nursing

Ohio

Reduced Practice

Standard Care Arrangement (SCA) with a collaborating physician required

Ohio Board of Nursing

Oklahoma

Restricted Practice

Supervising physician relationship required for practice and prescribing

Oklahoma Board of Nursing

Oregon

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Oregon Board of Nursing

Pennsylvania

Reduced Practice

Collaborative agreement required

Pennsylvania Board of Nursing

Rhode Island

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Rhode Island Board of Nursing

South Carolina

Restricted Practice

Written scope-of-practice / physician supervision agreement required

South Carolina Board of Nursing

South Dakota

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

South Dakota Board of Nursing

Tennessee

Restricted Practice

Collaborative practice physician required

Tennessee Board of Nursing

Texas

Restricted Practice

Delegating physician required for prescribing

Texas Board of Nursing

Utah

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Utah Board of Nursing

Vermont

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Vermont Board of Nursing

Virginia

Restricted Practice

Practice agreement with a supervising physician required for at least one element of practice

Virginia Board of Nursing

Washington

Full Practice Authority

Full independent practice

Washington Board of Nursing

West Virginia

Reduced Practice

Collaborative agreement with a physician required for prescriptive authority

West Virginia Board of Nursing

Wisconsin

Reduced Practice

Collaborative agreement with a physician required for at least one element of practice

Wisconsin Board of Nursing

Wyoming

Full Practice Authority

Full practice authority under the exclusive licensure authority of the state board of nursing

Wyoming Board of Nursing

Questions about NP scope of practice

NP scope of practice is the set of activities - evaluating patients, diagnosing, ordering and interpreting tests, and initiating and managing treatment including prescribing - that a nurse practitioner is legally permitted to perform in a given state, and whether a physician must be involved. It is set by each state's Nurse Practice Act, not by a single national standard.

This tool uses public data from AANP and state nursing boards. Laws change - verify with your board before relying on this information.

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