From Coast to Coast: A Comparative Look at Nursing Certifications and Their Requirements Across States

Published 9:14 am Sunday, July 9, 2023

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Nursing certifications are a recognition of the registered nurses’ and nurse practitioners’ expertise gained from extensive, specialized coursework in nursing practice. To work as a professional nurse in the United States, each state has its unique set of conditions for certification and licensure that must be met.

For instance, nurse practitioner certificates for Texans require at least an Associate Degree in Nursing (ADN), whereas New York mandates a Bachelor of Science in Nursing (BSN). The type of certification awarded is dependent on the level of study and degree of proficiency demonstrated by the nurses, and it signifies their ability to deliver high-quality patient care.

How a Multistate Agreement Facilitates Nursing Practice in Different States

Thanks to the Nursing Licensure Compact, a multistate agreement in healthcare that provides opportunities for improved effectiveness and flexibility, nurses are now granted the ability to effortlessly cross not only physical state boundaries but also electronic ones. This signifies a momentous step in advancing access to the best possible care for patients.

However, when a nurse moves to a new state, they are required to give up their license granted by their previous state of residence. They must then apply and obtain a license in their new state of residence. It should be noted that the license a nurse holds is not a national state license, but instead, it is issued by the nurse’s primary state of residence, which is also known as the PSOR.

An Overview of Required Qualifications in the US

Nursing credentials are awarded to medical professionals who have achieved a certain level of educational attainments, such as passing examinations or completing continuing education programs. Without holding these credentials, medical professionals cannot practice within a particular state’s borders.

Depending on the level of care being provided, there may be additional certificates required in addition to the license. For registered nurses (RNs), an RN license is the minimum requirement to practice, and it is typically issued after completing a two- or four-year degree program in nursing and passing a licensing exam.

Worth mentioning is that some states may require additional certification beyond the RN license, depending on the level of care needed. To maintain their license, an RN may be required to complete continuing education courses on an ongoing basis. These courses cover a range of topics and are designed to keep the RN up-to-date with the latest medical advancements and nursing practices in the industry.

Achieving Excellence in Nursing: The Path to APRN Certification

Becoming an Advanced Practice Registered Nurse (APRN) requires more extensive training than a Certified Registered Nurse (RN). APRNs typically have either a master’s or doctorate in nursing, as well as an additional examination for licensure. APRNs have a wide range of tasks and responsibilities, including diagnosing and treating illnesses, prescribing medications and providing counseling.

Among the different APRNs, nurse practitioners (NP) are particularly specialized. Nurse practitioners are required to hold both an RN license and a specialty certification to practice, and there are several types of NP certifications available. These certifications include Family Nurse Practitioner (FNP), Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP) and Psychiatric Mental Health Nurse Practitioner (PMHNP).

Example Nursing Certifications by State: Texas

To practice as a registered nurse in Texas, passing the National Council Licensure Examination for Registered Nurses (NCLEX-RN) is mandatory as stipulated by the Board of Nursing. In addition, nurse practitioners should possess an APRN certification conferred by either the American Association of Nurse Practitioners or the American Nurses Credentialing Center.

Nurse practitioners interested in obtaining these certificates must complete two tests: the Certified Registered Nurse Practitioner Exam (CRNP-E) and Advanced Practice Registered Nurse Examination (APRN-E).


Healthcare professionals must remain informed of the nursing certifications and licensure requirements specific to the state in which they practice. The type of certification needed in order to practice nursing may differ between states, varying from RN license alone to APRN and specialty NP certifications.

For instance, nurse practitioners in Texas must hold an RN license along with two additional certificates before they are authorized to practice legally. Keeping up-to-date with these requirements will ensure that healthcare professionals are providing patients with safe and high-quality care.