To become a nurse practitioner (NP) in the US, you first become a licensed registered nurse (RN), then earn at least a master's degree in a nurse practitioner specialty, pass a national certification exam, and get an advanced practice registered nurse (APRN) licence from your state. Most programs prefer applicants with a bachelor's degree in nursing.
So there's no direct entry: the RN licence comes first, and the NP role is built on top of it. Bridge programs and accelerated routes exist, though, and they can shorten the path.
Facts below come from the US Bureau of Labor Statistics (BLS) Occupational Outlook Handbook profile for nurse anesthetists, nurse midwives and nurse practitioners, read on 26 October 2026. It's a careers guide, not clinical advice.
Nurse practitioner pay and outlook
| Measure | BLS figure |
|---|---|
| Median pay, nurse practitioners (May 2025) | $132,300 a year |
| Median pay, all three APRN roles | $134,920 a year |
| Jobs in 2025, all three APRN roles | 399,000 |
| Projected growth 2025 to 2035, all three roles | 36%, much faster than average |
| Openings each year, all three roles | About 32,200 on average |
Pay figures are as of October 2026. A projected 36% rise in a decade is far above the 3% BLS projects for all occupations.
From RN to NP: the steps
- Become a registered nurse. You need an RN licence before you can pursue advanced practice education.
- Ideally, earn a bachelor's degree in nursing. BLS says most APRN programs prefer it, though some offer bridge programs for RNs with an associate's degree or diploma.
- Choose your NP specialty and apply to an accredited master's program. Courses typically include advanced health assessment, pathophysiology and pharmacology, plus clinical experience.
- Consider a doctorate. A master's is the most common entry level, but some NPs earn a Doctor of Nursing Practice (DNP) or a Ph.D.
- Pass a national certification exam in your specialty. Most states require national certification to use an APRN title.
- Apply for your state APRN licence, and add any certifications employers ask for, such as BLS or ACLS.
The routes most people don't know exist
Two things widen the door more than people expect. First, BLS says some schools offer bridge programs for registered nurses who have an associate's degree or a diploma rather than a bachelor's. Second, graduate-level programs are available for people whose bachelor's degree is in a related health science rather than nursing, and those programs prepare you for the RN licensure exam as well as the APRN curriculum.
So if you already have a science degree and no nursing background, you don't necessarily have to start again with a four-year nursing degree. Ask schools specifically about these direct-entry or accelerated graduate routes.
Where nurse practitioners work
Physicians' offices employ the biggest share of the three APRN roles together, at 46%. Hospitals come next, at about 25 in every 100, then outpatient care centers at about 9 in every 100.
| Setting (all three APRN roles) | Median pay, May 2025 |
|---|---|
| Outpatient care centers | $143,370 |
| Hospitals; state, local and private | $142,240 |
| Educational services | $135,170 |
| Offices of physicians | $131,940 |
Those medians, as of October 2026, cover nurse anesthetists, nurse midwives and nurse practitioners together. In physicians' offices, APRNs typically work normal business hours; in hospitals they may work shifts, including nights, weekends and holidays.
NP, CRNA or nurse midwife?
All three are APRN roles, and they share the same basic route: RN licence, graduate degree, national certification, state licence. The differences are in the specialty and the prerequisites. Nurse anesthetists, for example, need 1 year of RN experience in a critical care setting before they can even apply. Nurse practitioners choose from a range of specialty areas, which is why the NP route suits nurses who aren't drawn to anesthesia or birth care. If you're early in your nursing career, it's worth shadowing all three before you choose.
Getting ready while you're still an RN
The years you spend as an RN aren't wasted time. They're where you work out which specialty suits you and build the clinical confidence graduate programs look for. A strong background in science helps too, BLS says. If you want flexibility while you study, our guides to remote options for registered nurses and RN remote jobs show what's out there.
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Choosing an NP program
Accreditation comes first, because you need a degree from an accredited program to sit the national certification exam. After that, compare the specialty tracks on offer, how clinical placements are arranged, and whether the program runs part time so you can keep working as an RN. If you have an associate's degree or a non-nursing bachelor's, ask directly whether the school offers a bridge or direct-entry route, since not every school does.
What the job demands
- Clinical judgement, because APRNs make decisions that affect patients' health.
- Stamina: BLS says APRN work can be physically and emotionally demanding.
- Flexibility, since some roles involve travelling to areas short of healthcare workers.
- A commitment to ongoing learning to keep your certification and licence current.
My verdict
Becoming a nurse practitioner is a long road, but it's one of the best-supported career moves in healthcare, with BLS projecting 36% growth for the APRN group and a median of $132,300 for NPs. Get your RN licence and some real clinical experience first, then pick your specialty with care. And if you're coming from another science degree, look closely at the direct-entry graduate programs: they can save you years.
Frequently asked questions
Do you have to be an RN to become a nurse practitioner?
Yes. BLS says APRNs must be licensed registered nurses, and an RN licence is needed before pursuing advanced practice education. Some graduate programs for non-nursing graduates prepare you for the RN exam along the way.
What degree do nurse practitioners need?
At least a master's degree in a nurse practitioner specialty. Some NPs go on to a Doctor of Nursing Practice (DNP) or a Ph.D.
How much do nurse practitioners make?
BLS reports a median of $132,300 a year for nurse practitioners in May 2025, as of October 2026.
Is there a nurse practitioner exam?
Yes. You pass a national certification exam in your specialty, and most states require national certification to use an APRN title.
Can I become an NP with an associate's degree in nursing?
Possibly. BLS says some schools offer bridge programs for registered nurses with an associate's degree or a diploma in nursing.
Is demand for nurse practitioners growing?
Yes. BLS projects employment of nurse anesthetists, nurse midwives and nurse practitioners to grow 36% from 2025 to 2035.
