A state board of nursing is the state-specific licensing and regulatory body that sets the standards for safe nursing care, decides the scope of practice for nurses within its jurisdiction, and issues licenses to qualified candidates.
All 50 states, the District of Columbia, American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands have boards of nursing that collectively represent the member organizations that make up the National Council of State Boards of Nursing (NCSBN). The NCSBN administers the National Council Licensure Examinations that all state boards require as part of the licensing process:
- Registered Nurses (including advanced practice RNs) – NCLEX-RN exam
- Licensed Practical or Vocational Nurses – (NCLEX-PN) exam
California, Georgia, Louisiana, and West Virginia have two boards, one for Registered Nurses (RNs) and one for LPNs or LVNs. One state, Nebraska, has a separate board for advanced practice registered nurses (APRNs).
How State Nursing Licensure Works
State legislatures pass Nursing Practice Acts (NPAs) that establish state regulations for nurses. The NPA lays out the requirements for licensure and defines the scope of nursing practice. State boards of nursing then put the NPA into practice by setting administrative rules and regulations that further define the qualifications for licensure and the scope of practice. Board rules must be consistent with the NPA and can’t supersede NPA mandates.
All boards of nursing are responsible for evaluating applications for nurse licensure, issuing and renewing nursing licenses, and taking disciplinary actions when needed. Other responsibilities that a board of nursing might take on, depending on the state, include:
- Authorizing the use of licensing examinations
- Approving nursing education programs that meet established criteria
- Offering advice to the legislature about determining the legal scope of nursing practice in the state
- Regulating nurse aides/nursing assistants and medication aides/assistants working in nursing home and home health care settings
State Nursing Boards and APRN Licensing
Just as every state has its requirements for RN licensing, each state also sets its own requirements for licensing APRNs, while also determining the legal scope of practice for APRNs and establishing the APRN roles and titles recognized in the state.
Variations in state laws for APRNs and the confusion they have created for both nurses and consumers has led a coalition of nursing organizations led by the NCSBN to develop the Consensus Model for APRN Regulation, which is an attempt to standardize APRN licensure requirements and scope of practice nationwide.
In recent years, most states boards of nursing have adopted at least some part of the NCSBN’s APRN Consensus Model. As of March 2017, nursing boards in 16 states plus the District of Columbia allow APRNs to independently prescribe certain drugs, diagnose and treat patients without direct physician oversight or a collaborative agreement in place. This widespread trend to adopt the consensus model strongly suggests that additional state boards of nursing will soon tailor their regulations to match this model.
Alabama
- Independent Practice for CNS
- Licensing for CNP, CNA, and CNM, but Not Independent Practice or Prescriptive Authority
- Alabama APN Scope of Practice
Alaska
- Independent Practice and Prescriptive Authority for All APNs: CNP, CRNA, CNS, CNM
- Alaska APN Scope of Practice
- CNP: Article 4 Sections 430 and 440
- CRNA: Article 5
Arizona
Arizona State Board of Nursing
- Independent Practice and Prescriptive Authority for CNP and CNM (licensed as a population focus of CNP)
- Independent Practice Without Prescriptive Authority for CNS
- Licensing for CRNA, but Not Independent Practice or Prescriptive Authority
- Arizona APRN Scope of Practice Article 5 (page 42)
Arkansas
Arkansas State Board of Nursing
- Independent Practice Authority for CNP and CNS, but No Prescriptive Authority
- Licensing for CRNA and CNM without Independent Practice or Prescriptive Authority
- Arkansas APRN Scope of Practice
- Collaborative Practice Agreements
California
California Board of Registered Nursing
- Independent Practice, but No Prescriptive Authority for CRNA
- Licensing for CNP, CNM, and CNS but No Independent Practice or Prescriptive Authority
- California APN Scope of Practice
- CNP
- CNM
- CNS
Colorado
- Independent Practice and Prescriptive Authority for All APNs: CNP, CNRA, CNM, CNS
- Colorado APN Scope of Practice
Connecticut
Connecticut Department of Public Health
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CNRA, CNM, and CNS
- Connecticut APRN Scope of Practice
Delaware
- Independent Practice and Prescriptive Authority for CNP and CRNA
- Independent Practice, but No Prescriptive Authority for CNM
- Licensing for CNS, but No Independent Practice or Prescriptive Authority
- Delaware APRN Scope of Practice Section 1935
District of Columbia
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CNRA, CNM, and CNS
- DC APRN Scope of Practice Subchapter VI page 37
Florida
- Licensing for ARNP roles CNP, CRNA, and CNM, but No Independent Practice or Prescriptive Authority
- Florida ARNP Scope of Practice
Georgia
- Licensing for All APRNs: CNP, CRNA, CNM, and CNS, but No Independent Practice or Prescriptive Authority
- Georgia APRN Scope of Practice Decision Tree
Hawaii
- Independent Practice and Prescriptive Authority for All ARPNs: CNP, CNRA, CNM, and CNS
- Hawaii APRN Scope of Practice page 89-47
Idaho
State of Idaho Board of Nursing
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CNRA, CNM, and CNS
Illinois
Illinois Department of Financial & Professional Regulation – Nursing
- Licensing for APN roles CNP, CRNA, and CNM, but No Independent Practice or Prescriptive Authority
- Illinois APN Collaborative Agreement
Indiana
Indiana State Board of Nursing
- Licensing and Prescriptive Authority for APN roles CNP, CRNA, and CNM, but No Independent Practice
- Indiana APN Collaborative Agreement Example
Iowa
- Independent Practice and Prescriptive Authority for All ARNPs: CNP, CNRA, CNM, and CNS
Kansas
- Independent Practice for CRNA, but Cannot Dispense prescriptions
- Licensing for CNP, CNM, and CNS, but No Independent Practice or Prescriptive Authority
- Kansas APRN Scope of Practice
- Kansas APRN Collaborative Practice
Kentucky
- Independent Practice for All APRNs: CNP, CNRA, CNM, and CNS, but No Prescriptive Authority
- Kentucky APRN Scope of Practice
Louisiana
Louisiana State Board of Nursing
- Licensing and Prescriptive Authority for APRN roles CNP, CRNA, and CNM, but No Independent Practice
- Louisiana APRN Scope of Practice
- Louisiana APRN Collaborative Practice Agreement
Maine
- Independent Practice and Prescriptive Authority for CNP and CNM
- Independent Practice for CNS, but No Prescriptive Authority
- Licensing for CNRA, but No Independent Practice or Prescriptive Authority
- Maine APRN Scope of Practice
Maryland
- Independent Practice for CNP and CNM, but No Prescriptive Authority
- Independent Practice for CNS, but No ability to prescribe
- Licensing for CRNA, but No Independent Practice or ability to prescribe
- Maryland APRN Scope of Practice: CNP, CNM, CNS, CRNA
- Maryland CRNA Collaborative Agreement
Massachusetts
Mass.gov Board of Registration in Nursing
- Independent Practice and Prescriptive Authority for CNM, CNP, and CRNA
- Licensing for CNS, but No Prescriptive Authority
- Massachusetts APRN Scope of Practice and Prescriptive Authority Guidelines
Michigan
- Licensing for APRN Roles CNP, CNM CNS
- APRNs Have Prescriptive Authority for Nonscheduled Drugs
- Michigan APRN Scope of Practice
Minnesota
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CNM, CNS
- Minnesota APRN Scope of Practice
Mississippi
- Licensing, but No Independent Practice for APRN roles: CNP, CRNA CNM
- Mississippi APRN Scope of Practice Part 2840
Missouri
- Licensing and Prescriptive Authority for APRN roles CNP, CRNA, CNM, and CNS but No Independent Practice
- Missouri APRN Prescriptive Authority Form
Montana
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CNM, and CNS
- Montana APRN Prescriptive Authority
Nebraska
Nebraska Department of Health & Human Services – Nursing
- Independent Practice and Prescriptive Authority for CNP, CNM and CRNA
- Independent Practice for CNS, but No Ability to Prescribe
- Nebraska APRN Scope of Practice
Nevada
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CNM, and CNS
- Nevada APRN Scope of Practice
New Hampshire
New Hampshire Board of Nursing
- Independent Practice and Prescriptive Authority for CNP, CRNA, and CNM
- Licensing for CNS, but Not Independent Practice or Prescriptive Authority
- New Hampshire APRN Scope of Practice
New Jersey
- Licensing for CNP, CNM, and CNS, but No Independent Practice
- CNP, CNM, and CNS Have Prescriptive Authority if They Have a Collaborative Agreement
- Licensing for CRNA, but No Independent Practice or Ability to Prescribe
- New Jersey APN Scope of Practice Page 52
New Mexico
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CNM, and CNS
- New Mexico APRN Scope of Practice
New York
New York State Office of the Professions – Nursing
- Licensing for CNP and CNS, but No Independent Practice or Prescription Authority
- Scope of Practice and Sample Collaborative Agreement for CNP
North Carolina
North Carolina Board of Nursing
- Independent Practice for APRN roles CRNA and CNS, but No Ability to Prescribe
- Licensing for APRN roles CNP and CNM, but No Independent Practice or Prescriptive Authority
- North Carolina Collaborative Practice Guidelines for CNP
- North Carolina Scope of Practice for CRNA
- North Carolina Scope of Practice for CNS
North Dakota
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CN, and CNS
- North Dakota APRN Scope of Practice
Ohio
State of Ohio Board of Nursing
- Licensing for All APRNs: CNP, CRNA, CN, and CNS, but No Independent Practice or Prescriptive Authority
- Ohio APRN Scope of Practice Decision Making Model
- Ohio APRN Collaborative Agreement
Oklahoma
- Independent Practice for APRN roles CNP, CNM, and CNS, but No Prescriptive Authority
- Licensing for CRNA, but No Independent Practice or Prescriptive Authority
Oregon
- Independent Practice and Prescriptive Authority for APRN roles CNP, CRNA, and CNS
- Prescriptive Authority Required for CNP but Optional for CRNA and CNS
- Oregon CNP Scope of Practice Section 851-050-005
Pennsylvania
- Independent Practice and Prescriptive Authority for CNP and CNM
- Pennsylvania CNP Scope of Practice
- Pennsylvania CNP Application for Prescriptive Authority
Rhode Island
State of Rhode Island Department of Health – Nursing
- Independent Practice and Prescriptive Authority for APRN roles CNP and CRNA
- Independent Practice for CNS, but No Prescriptive Authority
South Carolina
South Carolina Board of Nursing
- Licensing for All APRNs: CNP, CRNA, CN, and CNS, but No Independent Practice or Prescriptive Authority
South Dakota
- Licensing for APRN roles CNP and CNM, but No Independent Practice or Prescriptive Authority
- Licensing for APRN roles CRNA and CNS, but No Independent Practice or ability to prescribe
- South Dakota CNP Collaborative Agreement
Tennessee
- Licensing for All APNs: CNP, CRNA, CN, and CNS,
- APNs Can Apply for Prescriptive Authority if They Have Taken the Required Pharmacology Classes
Texas
- Licensing for All APRNs: CNP, CRNA, CN, and CNS, but No Independent Practice
- Texas APRNs Can Apply for Prescriptive Authority
- Texas APRN Scope of Practice
Utah
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CN, and CNS
Vermont
- Independent Practice and Prescriptive Authority for All APRNs: CNP, CRNA, CN, and CNS
Virginia
- Independent Practice and Prescriptive Authority for CRNA
- Licensing for APRN Roles CNP, CNS and CNM, but No Independent Practice or Automatic Prescriptive Authority
- CNP Can Apply for Prescriptive Authority
Washington
Washington State Department of Health Nursing Commission
- Independent Practice and Prescriptive Authority for All ARNPs: CNP, CRNA, CN, and CNS
- Washington State ARNP Scope of Practice
West Virginia
- Independent Practice and Prescriptive Authority for APRN roles CRNA and CNS
- Independent Practice for CNP and CNM, but No Prescriptive Authority
- West Virginia APRN Scope of Practice
Wisconsin
- Independent Practice for APNP Roles CNP, CRNA, and CNS, but No Prescriptive Authority
- Licensing for CNM, but No Independent Practice or Prescriptive Authority
Wyoming
Wyoming State Board of Nursing
- Independent Practice and Prescriptive Authority for APRN Roles CRNA, CNM, and CNS
- Independent Practice for CNP, but No Prescriptive Authority
