Across the country, nurse practitioners (NPs) continue to help meet the growing demand for healthcare by providing high-quality, patient-centered care. With more than 400,000 NPs currently practicing in the United States and projected employment growth of 46% from 2023 to 2033, according to the U.S. Bureau of Labor Statistics, the profession is playing an increasingly important role in supporting access to care.

As demand for healthcare grows and care delivery evolves, nurse practitioners are exploring new ways to expand their impact. Many are stepping into independent roles, joining collaborative care teams, or choosing locum tenens assignments that offer greater flexibility and reach. For those considering a more autonomous path, understanding where nurse practitioners can practice independently is an important part of the decision-making process.

The Scope and Reach of Nurse Practitioners

Today's nurse practitioners provide care across every setting. They work in outpatient clinics, hospitals, emergency departments, specialty practices, and other healthcare settings. According to the American Association of Nurse Practitioners (AANP), approximately 88% of NPs are certified in primary care, and more than 70% actively deliver primary care services. Many also support hospital-based care, with nearly half holding hospital privileges. Their contributions span emergency departments, oncology units, cardiology practices, mental health clinics, and more.

With advanced clinical training and a strong focus on prevention, NPs are uniquely positioned to support patients throughout their health journeys. Whether working in team-based environments or independently managing care, their contributions are helping improve access to care across the country.

States Where Nurse Practitioners Can Practice Independently

For nurse practitioners wondering where they can practice independently, 28 states, as well as Washington, D.C., grant what is known as full practice authority, according to the AANP. This means NPs in these states are licensed to evaluate patients, diagnose conditions, order and interpret diagnostic tests, and initiate and manage treatment plans. This also includes prescribing medications and controlled substances under the oversight of the state board of nursing.

States That Grant Full Practice Authority to Nurse Practitioners Include:

Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Michigan, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, and Wyoming.

Nurse Practitioner State Practice Environment

  • =Independent Practice
  • =Reduced Independent Practice
  • =Supervision Required

It's important to note that these regulations are subject to change as laws evolve, so always check the current guidelines if you’re an NP interested in practicing independently.

States with Reduced Practice Authority for Nurse Practitioners

Twelve states currently operate under a reduced practice model, where nurse practitioners face limitations in at least one area of their scope of practice. These limitations often involve collaborative or supervisory agreements with a physician.

States With Reduced Nurse Practitioner Practice Authority Include:

Alabama, Arkansas, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Jersey, Ohio, Pennsylvania, West Virginia, and Wisconsin.

The remaining states are categorized as having restricted practice authority. In these states, nurse practitioners are subject to practice limitations defined by state laws.

Practice Setting Considerations for Nurse Practitioners

Every NP's career path is unique. Some nurse practitioners opt for full-practice roles that enable them to work independently and manage a wide range of patient needs. Others prefer collaborative settings where mentorship, structure, and team-based care support their growth. Many find value in both models at different stages of their careers.

Regardless of where an NP is in their career journey, it is important to select a practice model that aligns with their goals and supports their professional development. Whether seeking autonomy, skill-building, or work-life balance, there are many ways to build a fulfilling and flexible career as an NP.

The Benefits of Working Locum Tenens as a Nurse Practitioner

While state laws determine the level of practice authority, nurse practitioners do not have to be limited by geography. Working as a locum tenens nurse practitioner offers the flexibility to choose where, when, and how they practice, regardless of whether a state offers full, reduced, or restricted authority.

Nurse practitioner locum tenens assignments enable NPs to experience a diverse range of clinical settings, including outpatient clinics, hospitals, rural health centers, and specialty practices. Locum tenens nurse practitioner jobs offer the opportunity to develop new skills, experience diverse care models, and tailor their schedules to suit their lifestyle. For many NPs, it is also a way to expand access to care in communities facing provider shortages.

At Medicus, we collaborate with nurse practitioners to match each locum tenens assignment to align with their goals. Whether an NP is looking to practice independently, broaden their scope of experience, or maintain flexibility in their career, working as a locum tenens nurse practitioner can serve as a strategic next step.

The Future of Nurse Practitioner Care

As more states consider expanding practice authority and the need for accessible care continues to rise, nurse practitioners are helping shape a stronger and more responsive healthcare system. Whether working independently or as part of a collaborative team, in permanent positions or through locum tenens, NPs are essential to meeting today's rising demands for care.

Interested in working as a locum tenens nurse practitioner with Medicus? View our open locum tenens nurse practitioner jobs here, or complete the form below to connect with a Medicus recruiter.