In the United States, there are over 355,000 licensed nurse practitioners (NPs), making it the fastest-growing occupation. NPs enjoy the benefits of flexibility and ample opportunities for career advancement. They have the freedom to choose the states that provide the best environment to start or continue their professional journey.
To determine the best states for NPs to work in, NurseJournal conducted a data-driven analysis. Moreover, we collaborated with Elizabeth Clarke, FNP, MSN, RN, MSSW and Joelle Y. Jean, FNP-C, BSN, RN, who provided valuable insights to rank the factors that NPs consider most crucial when selecting an ideal state.
Our methodology is based on metrics that Clarke and Jean identified as significant for NPs. These metrics encompass a comprehensive evaluation of nine different variables.
- Independent Practice
- Pre-Pandemic Job Satisfaction (2018)
- Projected Job Growth
- Projected NP Job Openings Per Year
- NPs Currently Employed
- Average Hourly Salary
- Purchasing Power
- Outpatient NPs’ Annual Average Salary Adjusted for Cost of Living
- Hospital NPs’ Annual Average Salary Adjusted for Cost of Living
Discover the top states for Nurse Practitioners (NPs), where you’ll find higher salaries, independence in practice, job satisfaction, and abundant professional development opportunities.
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The Top 10 States for Nurse Practitioners
Nurse Practitioners (NPs) have a crucial role in healthcare delivery, making their work/life balance a key consideration. Discover the top 10 states where NPs can truly flourish, backed by data from the Bureau of Labor Statistics (BLS) and Projections Central. We’ve examined average salaries and projected job openings for each state to provide you with valuable insights.
1. Arizona
Arizona claims the coveted title of the best state for NPs to work in. With full practice authority and prescriptive privileges, NPs can operate independently, unbound by the need for a collaborating agreement with a physician. Renowned for its diverse climate, boasting scorching summers and mild winters, Arizona provides an ideal environment to establish a thriving practice.
- Weighted Average Score: 0.940
- Average Annual NP Hourly Salary: $58.37
- Projected NP Job Openings Per Year between 2020-2030: 910
- Top Three Strengths: Projected job growth, projected NP job openings per year, independent practice
- Top Three Weaknesses: Outpatient salary for cost of living, average hourly salary, purchasing power
2. New Mexico
Nurse Practitioners in New Mexico enjoy above-average annual salaries, earning $62.29 per hour. Furthermore, they benefit from full practice authority and prescription privileges in the state. However, the downside is that there are only projected to be 1,400 job openings from 2020 to 2030.
- Weighted Average Score: 0.896
- Average Annual NP Hourly Salary: $62.29
- Projected NP Job Openings Per Year between 2020-2030: 140
- Top Three Strengths: Independent practice, outpatient salary for cost of living, hospital salary for cost of living
- Top Three Weaknesses: Projected NP job openings per year, NPs currently employed, average hourly salary
3. Iowa
Nurse Practitioners (NPs) in Iowa benefit from autonomous practice and the ability to prescribe medication. Additionally, NPs working in hospitals enjoy a favorable cost of living. Over the next decade, the projected number of job openings for NPs is less than 3,000, ensuring a healthy supply of employment opportunities. Moreover, Iowa’s climate, characterized by four distinct seasons, adds to the appeal for NPs seeking both professional growth and a pleasant living environment.
- Weighted Average Score: 0.893
- Average Annual NP Hourly Salary: $61.62
- Projected NP Job Openings Per Year between 2020-2030: 260
- Top Three Strengths: Independent practice, hospital salary for cost of living, projected job growth
- Top Three Weaknesses: Projected NP Job openings per year, NPs currently employed, pre-pandemic job satisfaction
4. New York
New York consistently ranks as one of the best states for nurses to work, offering a perfect blend of urban and suburban lifestyles. Nurse practitioners in New York enjoy lucrative salaries and abundant job opportunities for years to come. They can even explore the realm of independent practice by opening clinics and embracing entrepreneurship. However, it’s worth noting that job satisfaction among NPs in New York was slightly lower than the national average pre-pandemic, with only 40% expressing satisfaction compared to 47% nationally. Additionally, the cost of living in New York can be high, depending on your chosen location.
- Weighted Average Score: 0.884
- Average Annual NP Hourly Salary: $64.39
- Projected NP Job Openings Per Year between 2020-2030: 2,060
- Top Three Strengths: Projected NP job openings per year, NPs currently employed, independent practice
- Top Three Weaknesses: Pre-Pandemic job satisfaction, purchasing power, outpatient salary for cost of living
5. Oregon
Oregon is a state that grants NPs full practice authority and prescription privileges. Additionally, it boasts the fourth-highest hourly salary in the country, with NPs earning an impressive $65.51. The state also stands out for its strong job growth, as reported by BLS. However, it’s important to note that the higher-than-average hourly rate comes with the potential drawback of a high cost of living, which varies depending on your location within the state. Furthermore, Oregon’s diverse landscapes contribute to mixed weather patterns, adding to its unique charm.
- Weighted Average Score: 0.883
- Average Annual NP Hourly Salary: $65.51
- Projected NP Job Openings Per Year between 2020-2030: 300
- Top Three Strengths: Independent practice, projected job growth, average hourly salary
- Top Three Weaknesses: NPs currently employed, projected NP job openings per year, purchasing power
6. Minnesota
Minnesota, known as the home of the twin cities, provides nurse practitioners (NPs) with the opportunity to enjoy independent practice, competitive compensation with an average hourly salary of $61.62, and a comfortable income adjusted for the cost of living, especially for those working in hospitals. The state experiences distinct seasons, with snowy winters and warm summers, offering a diverse climate. With a population of 5.7 million, there is a projected increase of 4,500 NP job openings in the next 10 years.
- Weighted Average Score: 0.883
- Average Annual NP Hourly Salary: $61.62
- Projected NP Job Openings Per Year between 2020-2030: 450
- Top Three Strengths: Independent practice, average hourly salary, hospital salary for cost of living
- Top Three Weaknesses: Outpatient salary for cost of living, projected NP job openings per year, projected job growth
7. Washington
Washington provides lucrative salaries for NPs, who can also benefit from the autonomy of independent practice and prescription privileges. As of 2022, the state boasts a population of approximately 7.7 million, with a projected 6,900 job openings for NPs in the next decade. NPs in Washington can relish a blend of outdoor living and urban amenities, creating an enviable lifestyle.
- Weighted Average Score: 0.878
- Average Annual NP Hourly Salary: $65.19
- Projected NP Job Openings Per Year between 2020-2030: 690
- Top Three Strengths: Independent practice, projected NP job openings per year, average hourly salary
- Top Three Weaknesses: NPs currently employed, outpatient salary for cost of living, purchasing power
8. Montana
In 2018, Nurse Practitioners (NPs) in Montana reported a pre-pandemic job satisfaction rate of 50%. NPs in Montana have the advantage of being able to practice independently and enjoy prescription privileges. Moreover, the job market in Montana shows promise, and the cost of living is relatively close to the national average. Known as the “Big Sky Country” and nestled in the breathtaking Rocky Mountains, Montana offers NPs the opportunity to embrace an outdoor lifestyle while pursuing their careers.
- Weighted Average Score: 0.856
- Average Annual NP Hourly Salary: $57.67
- Projected NP Job Openings Per Year between 2020-2030: 80
- Top Three Strengths: Independent practice, pre-pandemic job satisfaction, projected job growth
- Top Three Weaknesses: NPs currently employed, projected NP job openings per year, outpatient salary for cost of living
9. New Hampshire
New Hampshire is renowned for its plethora of outdoor activities, making it an ideal location for nurse practitioners (NPs) to thrive. With its above-average national salary, as well as the autonomy to practice independently and prescribe medications, New Hampshire offers a promising professional environment. However, it is worth noting that New Hampshire ranks relatively lower in terms of pre-pandemic job satisfaction, standing at 38%.
- Weighted Average Score: 0.834
- Average Annual NP Hourly Salary: $60.47
- Projected NP Job Openings Per Year between 2020-2030: 140
- Top Three Strengths: Average hourly salary, independent practice, and hospital NP salary adjusted for cost of living
- Top Three Weaknesses: Projected NP job openings per year, projected job growth, and NPs currently employed
10. North Dakota
Despite having the second lowest projected number of NP job openings in the next 10 years (900, just behind Montana), NPs who choose to work in a hospital setting can earn an annual salary of over $130,000 after adjusting for the cost of living. Additionally, NPs enjoy the benefits of independent practice and prescription privileges. It’s worth noting that North Dakota experiences significant temperature variations, so prepare for both cold and warm weather conditions.
- Weighted Average Score: 0.832
- Average Annual NP Hourly Salary: $54.78
- Projected NP Job Openings Per Year between 2020-2030: 90
- Top Three Strengths: Purchasing power, independent practice, and hospital NP salary adjusted for cost of living
- Top Three Weaknesses: Projected NP job openings per year, projected job growth, and NPs currently employed
Find out Where Your State Ranks
States that Offer Nurse Practitioners (NP) the Largest Scope of Practice
Nurse practitioners (NPs) in states with the broadest scope of practice enjoy significant benefits. These states empower NPs to provide the highest level of care independently, without the need for physician supervision. NPs should strongly consider pursuing independent practice authority and prescriptive privileges. These privileges not only enhance professional autonomy but also expand access to healthcare, particularly in underserved communities and rural areas. By optimizing NPs’ ability to serve, we can bridge the gaps in healthcare and ensure quality care for all.
List of States Where Nurse Practitioners Can Practice at the Top of Their Licenses
- Alaska
- Arizona
- Washington D.C.
- Idaho
- Iowa
- Minnesota
- Montana
- New Hampshire
- New Mexico
- North Dakota
- Oregon
- Rhode Island
- Washington
- Wyoming
According to the American Association of Nurse Practitioners, states that offer full practice authority allow NPs to “evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing.”
In Alaska, for instance, nurse practitioners (NPs) possess prescriptive, controlled substance, and dispensing authority. However, in states where NPs have limited or restricted authority, they can only prescribe medications with explicit permission and approval from a physician. Nevertheless, it is important to note that even in states where NPs have full-practice authority, there are still additional laws and requirements to adhere to.
What full-authority NPs are allowed to do under their license varies by state. For example, NPs in New York must have written practice agreements with collaborating physicians unless they have met 3,600 clinical experiences. Other states allow NPs to practice without a collaborating physician and prior clinical experience outside the required amount in their NP programs.
States that grant full-practice authority to nurse practitioners (NPs) acknowledge their ability to deliver exceptional care to patients. These states also acknowledge the pressing need to enhance healthcare access for vulnerable communities. However, in order for states with reduced and restricted authority to transition to full-practice authority, appropriate legislation must be enacted.
The States With the Most Opportunities for Nurse Practitioners
The states with the most job opportunities can attract NPs starting their careers or looking for a change. These states can offer job security, professional retention and development, higher pay and improved healthcare outcomes. However, NPs should be aware that states with the highest projected job growth may not be the states with the highest number of openings for NPs.
| State | Opportunity Index | NPs Currently Employed | Projected Job Growth | Projected NP Job Openings Per Year |
|---|---|---|---|---|
| Texas | 0.86 | 18,820 | 66.00% | 2,010 |
| Florida | 0.86 | 18,530 | 70.80% | 1910 |
| California | 0.85 | 19,130 | 55.50% | 2,120 |
| New York | 0.82 | 17,670 | 55.60% | 2,060 |
| Georgia | 0.60 | 8,110 | 78.60% | 1,250 |
| Arizona | 0.59 | 6,240 | 100.80% | 910 |
| Tennessee | 0.58 | 13,060 | 57.20% | 1,020 |
| Ohio | 0.52 | 10,730 | 48.60% | 1100 |
| Massachusetts | 0.45 | 7,190 | 55.70% | 890 |
| New Jersey | 0.44 | 6,640 | 61.30% | 800 |
Before making a decision, it is crucial to thoroughly investigate job prospects and demand for NPs. For instance, according to Clarke, states with the greatest demand for NPs might indicate low job satisfaction. Clarke states, “High turnover is often indicative of low job satisfaction, whereas low turnover or fewer job openings suggest higher job satisfaction.” Remember to consider these factors when assessing your options.
The Best States for Nurse Practitioner (NP) Salaries
According to the BLS, NPs earned a mean annual salary of $124,680 in 2022 or an average hourly wage of $59.94. However, NPs can make up to $2-$16 more if they work in the top 10 states with the best salaries for NPs.
When considering working in a specific state, it’s crucial to take into account the cost of living and salary potential. Nurse practitioners (NPs) should feel empowered to negotiate their salaries and incorporate living expenses, such as housing, food, and transportation, into their contracts.
If NPs encounter difficulty finding a salary that aligns with their needs, the choice between working in a hospital or an outpatient center may become the deciding factor. NPs employed by hospitals tend to earn significantly higher salaries compared to those working in outpatient centers.
For instance, NPs practicing in New Mexico and employed by hospitals earn an average annual salary of $151,313. Conversely, outpatient NPs in New Mexico receive an annual salary of $144,104, accounting for the state’s cost of living.
Furthermore, we analyzed the purchasing power of NP salaries. In states like Iowa and New Mexico, NP salaries can purchase goods that are 10% more affordable than the national average.
| State | Salary Index | NP Average Hourly Salary | Outpatient NP Annual Average Salary Adjusted for Cost of Living | Hospital NP Annual Average Salary Adjusted for Cost of Living |
|---|---|---|---|---|
| New Mexico | 0.94 | $62.29 | $144,104.46 | $151,313.42 |
| Iowa | 0.93 | $61.62 | $143,109.15 | $150,252.41 |
| Nevada | 0.95 | $65.49 | $142,585.01 | $149,702.40 |
| California | 0.99 | $76.02 | $141,443.87 | $148,508.17 |
| Mississippi | 0.87 | $56.38 | $135,402.59 | $142,185.33 |
| Oklahoma | 0.88 | $58.53 | $134,863.57 | $141,609.54 |
| Oregon | 0.90 | $65.51 | $132,240.47 | $138,863.50 |
| New Jersey | 0.91 | $68.87 | $131,302.76 | $137,867.51 |
| Indiana | 0.86 | $58.53 | $131,266.51 | $137,843.88 |
| Montana | 0.86 | $57.67 | $131,007.90 | $137,550.95 |
The Complete Ranking of the Best States to Work as a Nurse Practitioner (NP)
Methodology and Sources
We determined the best states for NP employment by calculating a weighted average ranking across nine key metrics. These metrics include scope of practice, average hourly salary for NPs, state purchasing power, adjusted average annual salary for outpatient NPs based on cost of living, adjusted average annual salary for hospital NPs based on cost of living, projected job growth, projected NP job openings per year, number of NPs currently employed, and pre-pandemic job satisfaction.
The salary index score is calculated as the average of the average hourly salary index, the average annual salary for outpatient NPs adjusted for the cost of living index, and the average annual salary for hospital NPs adjusted for the cost of living index. Similarly, the opportunity index is calculated as the average of each state’s projected NP annual openings index and current NP employment index.
Sources include Projections Central, the Bureau of Labor Statistics, American Association of Nurse Practitioners, BEA Regional Price Parity, Health Resources and Services Administration (HRSA) Nursing Workforce Dashboard, American Medical Association’s State law chart: Nurse Practitioner Prescriptive Authority from 2017, and The U.S. Department of Justice’s Mid-Level Practitioner Controlled Substance Authorization by State Guide, which was last updated in 2022
The authority to practice as a nurse practitioner was transferred from the American Association of Nurse Practitioners. The power to prescribe medications was derived from the State law chart on Nurse Practitioner Prescriptive Authority from 2017, published by the American Medical Association, and The U.S. Department of Justice’s Mid-Level Practitioner Controlled Substance Authorization by State Guide, which was last updated in 2022.
Data on projected job openings per year and job growth for nurse practitioners were sourced from Projections Central’s 2020-2030 data. Purchasing power was determined using the 2021 regional price parity from the BEA Regional Price Parity in each state. Information on currently employed nurse practitioners and average hourly salary was collected from Bureau of Labor Statistics data from 2022. For New York, salary data from 2021 was used due to the unavailability of 2022 data.
Purchasing power allows nurse practitioners to understand the relative value of their paycheck in their state compared to the national purchasing power. By multiplying each state’s average outpatient nurse practitioner salary and average nurse practitioner salary by the purchasing power, we were able to determine the adjusted outpatient and hospital nurse practitioner salaries in each state, accounting for the cost of living.
Job satisfaction was assessed based on the percentage of NPs in each state who reported being “extremely satisfied” with their role, as per the Health Resources and Services Administration (HRSA) Nursing Workforce Dashboard. The dashboard, which employed 2018 data at the time of publication, lacks information on how the COVID-19 pandemic influenced NP job satisfaction as more recent data has not been released by the HRSA.
Interestingly, in several states, up to 24% of NPs refrained from reporting their job satisfaction to the HRSA. In cases where the sample size was small, such as Wyoming and Montana or North and South Dakota, the data from these states were combined, resulting in the utilization of the same percentage for both states.
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