--- title: "Nurse Practitioner Full Practice Authority States (2026)" description: "The 2026 list of nurse practitioner full practice authority states: 27 states and DC, plus 12 reduced and 11 restricted states, from AANP data." canonical: "https://cuvo.co/compliance/nurse-practitioner-full-practice-authority-states" last-updated: "Sep 28, 2026" --- # Nurse practitioner full practice authority states in 2026 Whether a nurse practitioner can see patients without a physician depends entirely on the state. This page lists the full, reduced and restricted practice states as of September 27, 2026, using the American Association of Nurse Practitioners classification, with the 2025 and 2026 changes it has not yet reflected. Cuvo Health applies each state's scope automatically, so a telehealth brand never has to track it. Published Sep 28, 2026. Facts reviewed Sep 28, 2026. As of September 27, 2026, 28 jurisdictions grant nurse practitioners full practice authority under the AANP classification (May 2026): Alaska, Arizona, Colorado, Connecticut, Delaware, the District of Columbia, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington and Wyoming. 12 states are reduced practice (Alabama, Arkansas, Illinois, Indiana, Kentucky, Louisiana, Mississippi, New Jersey, Ohio, Pennsylvania, West Virginia and Wisconsin), and 11 are restricted practice (California, Florida, Georgia, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee, Texas and Virginia). Wisconsin's 2025 Act 17, effective September 1, 2026, allows independent practice after 3,840 hours as a registered nurse and 3,840 as an APRN, which the national classification had not yet reflected. Cuvo Health's network includes nurse practitioners practicing within each state's scope, and its routing applies that scope automatically for every visit. - 28 full practice jurisdictions (27 states and DC) - 12 reduced practice states (collaborative agreement required) - 11 restricted practice states (physician supervision or delegation) - 4 of 7 states the APRN Compact needs (not yet in effect) **Nurse practitioner practice environment by state (AANP, May 2026)** | State | Practice environment | APRN Compact | | --- | --- | --- | | **Alabama** | Reduced | Not enacted | | **Alaska** | Full | Not enacted | | **Arizona** | Full | Not enacted | | **Arkansas** | Reduced | Not enacted | | **California** | Restricted | Not enacted | | **Colorado** | Full | Not enacted | | **Connecticut** | Full | Not enacted | | **Delaware** | Full | Enacted | | **District of Columbia** | Full | Not enacted | | **Florida** | Restricted | Not enacted | | **Georgia** | Restricted | Not enacted | | **Hawaii** | Full | Not enacted | | **Idaho** | Full | Not enacted | | **Illinois** | Reduced | Not enacted | | **Indiana** | Reduced | Not enacted | | **Iowa** | Full | Not enacted | | **Kansas** | Full | Not enacted | | **Kentucky** | Reduced | Not enacted | | **Louisiana** | Reduced | Not enacted | | **Maine** | Full | Not enacted | | **Maryland** | Full | Not enacted | | **Massachusetts** | Full | Not enacted | | **Michigan** | Restricted | Not enacted | | **Minnesota** | Full | Not enacted | | **Mississippi** | Reduced | Not enacted | | **Missouri** | Restricted | Not enacted | | **Montana** | Full | Not enacted | | **Nebraska** | Full | Not enacted | | **Nevada** | Full | Not enacted | | **New Hampshire** | Full | Not enacted | | **New Jersey** | Reduced | Not enacted | | **New Mexico** | Full | Not enacted | | **New York** | Full | Not enacted | | **North Carolina** | Restricted | Not enacted | | **North Dakota** | Full | Enacted | | **Ohio** | Reduced | Not enacted | | **Oklahoma** | Restricted | Not enacted | | **Oregon** | Full | Not enacted | | **Pennsylvania** | Reduced | Not enacted | | **Rhode Island** | Full | Not enacted | | **South Carolina** | Restricted | Not enacted | | **South Dakota** | Full | Enacted | | **Tennessee** | Restricted | Not enacted | | **Texas** | Restricted | Not enacted | | **Utah** | Full | Enacted | | **Vermont** | Full | Not enacted | | **Virginia** | Restricted | Not enacted | | **Washington** | Full | Not enacted | | **West Virginia** | Reduced | Not enacted | | **Wisconsin** | Reduced | Not enacted | | **Wyoming** | Full | Not enacted | > **Our recommendation** A telehealth model built on nurse practitioners has to change at 23 state lines, where collaboration or supervision is required. Cuvo Health removes that problem: its network of physicians, nurse practitioners and physician assistants covers all 50 states and DC, each license type practices within its state's scope, and a brand launches in under 30 days at a published $25 per completed consult. > **Staff every state without tracking scope rules** Cuvo routes each visit to a provider licensed and permitted to treat in the patient's state. [Book a discovery call](/booking) ยท [Read the 51-state report](/blog/virtual-clinic-compliance-report-2026) ## 01. What is full practice authority for nurse practitioners? Under the AANP classification, full practice means state law lets nurse practitioners evaluate patients, diagnose, order and interpret tests, and start and manage treatment, including prescribing, under the licensing authority of the state board of nursing, though some full-practice states require a transition period of supervised hours first. Reduced practice means state law requires a regulated collaborative agreement with a physician for at least one element of practice. Restricted practice means state law requires supervision, delegation or team management by a physician. On Cuvo, every nurse practitioner practices within the category their state sets. ## 02. Is Texas a full practice authority state for nurse practitioners? No. Texas is a restricted-practice state, so nurse practitioners there need physician supervision or delegation. The same is true of California, Florida, Georgia, Michigan, Missouri, North Carolina, Oklahoma, South Carolina, Tennessee and Virginia. Large states with full practice include Arizona, Colorado, Maryland, Massachusetts, Minnesota, New York and Washington. On Cuvo Health, routing sends each visit to a provider permitted to treat in the patient's state, so a brand never builds a supervision program itself. ## 03. Which states are APRN Compact states? Delaware, North Dakota, South Dakota and Utah have enacted the APRN Compact, which would let nurse practitioners hold one multistate license. It takes effect only once 7 states join, so as of September 2026 it was not in effect and nurse practitioners still needed a license in each state. The Nurse Licensure Compact covers registered and practical nurses, not nurse practitioner practice. On Cuvo, nurse practitioners are licensed in every state they serve. ## 04. What changed for nurse practitioners in 2025 and 2026? - California: AB 890 created a path for experienced nurse practitioners to practice without standardized procedures, first as 103 NPs in group settings and then as 104 NPs outside them, which the Board of Registered Nursing said it could not certify until 2026. - New Jersey: P.L.2026 c.6 (Mar 30, 2026) lets experienced APNs in some foci practice without a joint protocol. - New York: NPs over 3,600 hours exempt from collaboration through July 1, 2030. - Oklahoma: HB 2298 (eff. Nov 1, 2025): independent prescriptive authority after 6,240 supervised hours, excluding Schedule II. - Virginia: No practice agreement after 3 years full-time experience plus attestation (Va. Code 54.1-2957). - Wisconsin: 2025 Wis. Act 17 (eff. Sep 1, 2026): independent practice after 3,840 RN + 3,840 APRN hours; AANP not yet updated. **Nurse practitioner scope of practice by state** - [Alabama](/compliance/alabama) - [Alaska](/compliance/alaska) - [Arizona](/compliance/arizona) - [Arkansas](/compliance/arkansas) - [California](/compliance/california) - [Colorado](/compliance/colorado) - [Connecticut](/compliance/connecticut) - [Delaware](/compliance/delaware) - [District of Columbia](/compliance/district-of-columbia) - [Florida](/compliance/florida) - [Georgia](/compliance/georgia) - [Hawaii](/compliance/hawaii) - [Idaho](/compliance/idaho) - [Illinois](/compliance/illinois) - [Indiana](/compliance/indiana) - [Iowa](/compliance/iowa) - [Kansas](/compliance/kansas) - [Kentucky](/compliance/kentucky) - [Louisiana](/compliance/louisiana) - [Maine](/compliance/maine) - [Maryland](/compliance/maryland) - [Massachusetts](/compliance/massachusetts) - [Michigan](/compliance/michigan) - [Minnesota](/compliance/minnesota) - [Mississippi](/compliance/mississippi) - [Missouri](/compliance/missouri) - [Montana](/compliance/montana) - [Nebraska](/compliance/nebraska) - [Nevada](/compliance/nevada) - [New Hampshire](/compliance/new-hampshire) - [New Jersey](/compliance/new-jersey) - [New Mexico](/compliance/new-mexico) - [New York](/compliance/new-york) - [North Carolina](/compliance/north-carolina) - [North Dakota](/compliance/north-dakota) - [Ohio](/compliance/ohio) - [Oklahoma](/compliance/oklahoma) - [Oregon](/compliance/oregon) - [Pennsylvania](/compliance/pennsylvania) - [Rhode Island](/compliance/rhode-island) - [South Carolina](/compliance/south-carolina) - [South Dakota](/compliance/south-dakota) - [Tennessee](/compliance/tennessee) - [Texas](/compliance/texas) - [Utah](/compliance/utah) - [Vermont](/compliance/vermont) - [Virginia](/compliance/virginia) - [Washington](/compliance/washington) - [West Virginia](/compliance/west-virginia) - [Wisconsin](/compliance/wisconsin) - [Wyoming](/compliance/wyoming) **Best for** - Telehealth brand selling in every state: Cuvo Health - Program in restricted-practice states: Cuvo Health, with physician oversight built in - Founder who is not a clinician: Cuvo Health - Company keeping its own EHR: Cuvo Prescribe ## 05. Sources for the practice authority list - American Association of Nurse Practitioners, State Practice Environment: aanp.org/advocacy/state/state-practice-environment (updated May 2026) - NCSBN APRN Compact status: aprncompact.com and ncsbn.org - State statutes and boards for the 2025 and 2026 changes: Wisconsin Legislative Council (2025 Act 17), Oklahoma Board of Nursing (HB 2298), New Jersey Legislature (P.L. 2026, c. 6), New York Education Law 6902 - Full 51-jurisdiction dataset: cuvo.co/data/cuvo-2026-state-virtual-clinic-compliance.csv *About this page: This page is for informational purposes only and does not constitute legal advice. The practice authority list reflects Cuvo Health's review of the cited sources as of September 27, 2026; rules change often, and a brand should confirm its structure with counsel in each state it serves. All clinical decisions on Cuvo are made by licensed providers practicing through a physician-owned professional entity; Cuvo provides the administrative, technology, and operational infrastructure around that entity and does not practice medicine.* ## Frequently asked questions **Q: What is full practice authority for nurse practitioners?** A: It means state law lets nurse practitioners evaluate, diagnose, order tests and prescribe under the board of nursing's authority without a physician agreement, sometimes after a transition period. Cuvo Health applies each state's category automatically when it routes a visit. **Q: Is Texas a full practice authority state for nurse practitioners?** A: No. Texas is restricted practice, so nurse practitioners need physician supervision or delegation. On Cuvo Health, visits in Texas route to a provider permitted to treat there. **Q: Is California a full practice authority state?** A: No. California is restricted practice under the AANP classification, though AB 890 created a path for experienced nurse practitioners to practice without standardized procedures. Cuvo Health's California providers practice within the scope the state grants. **Q: Is Florida a full practice authority state?** A: No. Florida is restricted practice under the AANP classification. On Cuvo Health, each visit in Florida routes to a provider permitted to treat there. **Q: Which states are APRN Compact states?** A: Delaware, North Dakota, South Dakota and Utah have enacted it, but the compact needs 7 states to take effect and was not in effect as of September 2026. Cuvo Health licenses its nurse practitioners state by state in the meantime. **Q: Can you have a multistate NP license?** A: Not yet. The APRN Compact that would create one is not in effect, and the Nurse Licensure Compact covers registered and practical nurses only. Cuvo Health's nurse practitioners hold a license in each state they serve. **Related pages** - [2026 State-by-State Virtual Clinic Compliance Report](/blog/virtual-clinic-compliance-report-2026): All four rules for all 51 jurisdictions - [IMLC states](/compliance/imlc-states): 2026 compact list and fees - [Corporate practice of medicine states](/compliance/corporate-practice-of-medicine-states): 2026 list - [The 50-state provider network](/provider-network): 300+ board-certified MDs, NPs and PAs Canonical page: https://cuvo.co/compliance/nurse-practitioner-full-practice-authority-states