APRN vs NP: What's the Difference?

Every nurse practitioner is an advanced practice registered nurse, but not every APRN is a nurse practitioner. That single relationship explains most of the confusion between the two terms.

Key Takeaways

• All nurse practitioners (NPs) are advanced practice registered nurses (APRNs). The reverse is not true.
• The four APRN roles are nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists. They differ mainly in specialization and scope of duties.
• Becoming an NP requires an MSN or DNP plus a national certification exam. Other APRN roles have their own certification paths.
• NPs choose a specialty before licensure. Other APRNs can select a focus after they begin practicing.

The four types of APRN

A nurse practitioner is one of four APRN roles. The other three are nurse midwives, clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs). NPs work in a chosen area of medicine such as gerontology, women's health, or mental health. What separates the roles is not just specialty but the duties each one performs.

Roles and responsibilities

Nurse practitioners deliver primary care. Day to day, that means they:

• Diagnose acute and chronic illnesses and infections
• Order and interpret diagnostic tests such as EKGs and ultrasounds
• Review and analyze patient data
• Build treatment plans
• Perform physical assessments and in-office treatments
• Prescribe medication and, in full-practice states, run their own practices

The other APRN roles carry different responsibilities. CRNAs administer anesthesia and monitor patients before, during, and after procedures. Clinical nurse specialists develop practice policies and procedures and provide expert consultation to staff nurses. Nurse midwives manage prenatal and postnatal care, deliver newborns, educate new parents, and diagnose and treat sexually transmitted infections.

Where they work

NPs and other APRNs practice in hospitals, schools, community health clinics, private practices, birthing centers, long-term care and nursing homes, healthcare companies, correctional facilities, and specialty and urgent care clinics.

Specialties

NPs must choose a specialty before they are licensed. Common NP specialties include:

• Family: care and counseling across all ages, pediatric through elderly
• Psychiatric: mental health treatment for all ages
• Pediatric: care for children, most commonly ages zero to 18
• Neonatal: advanced care for newborns in labor and delivery and the ICU
• Adult-gerontology: acute and primary care for adults, from young adults to seniors
• Women's health: primary care focused on reproductive and gynecological health

Other APRNs can specialize after starting practice. CNSs work with a specific population (adults, children) or medical specialty (cardiology, oncology). CRNAs focus on areas like pediatric, obstetric, cardiovascular, or neurosurgical anesthesia.

Education

Every APRN holds an advanced degree. To become an NP, earn an MSN or a DNP. Most programs require a BSN for admission, though some accept associate degrees. Nurse midwives and CNSs need at minimum an MSN. CRNAs need an MSN plus a DNP or Doctor of Nurse Anesthesia Practice (DNAP).

Licenses and certification

You must be a registered nurse before becoming any kind of APRN. From there, the certification path depends on the role.

NPs complete their MSN or DNP, then pass the national certification exam for their specialty. NP certifications are offered by the American Academy of Nurse Practitioners Certification Board (AANPCB), the American Association of Critical-Care Nurses (AACN), the American Nurses Credentialing Center (ANCC), the Pediatric Nursing Certification Board (PNCB), and the National Certification Corporation (NCC). After passing, you apply for licensure in the state where you intend to practice and recertify every few years. Some states require separate prescriptive authority.

CRNAs pass the national exam administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA), a computer-based test of 100 to 170 questions. A doctoral degree and current RN license are required to sit for it. Nurse midwives pass a four-hour, 175-question exam from the American Midwifery Certification Board (AMCB). Clinical nurse specialists pass a specialty exam, often through the AACN, and must log a set number of direct-care hours first.

Salary and outlook

The U.S. Bureau of Labor Statistics reports a median annual wage of $129,210 for nurse practitioners as of May 2024 (BLS). Across the broader APRN category, which includes higher-paid nurse anesthetists, the median was $132,050, with the lowest 10 percent under $98,520 and the highest 10 percent above $217,270. Employment of nurse practitioners is projected to grow 40 percent from 2024 to 2034, far faster than the 3 percent average for all occupations.

Which path fits you

The choice between NP and another APRN role comes down to the care you want to deliver. If you want to provide primary care, the NP path fits. If you prefer a more administrative, policy-driven role, consider clinical nurse specialist. If you want to manage anesthesia, look at CRNA. None of these is a lesser choice. Each is demanding and well compensated.

Frequently Asked Questions

What is the difference between an APRN and an NP? APRN is the umbrella category for advanced practice registered nurses. A nurse practitioner is one of four APRN roles, so every NP is an APRN, but not every APRN is an NP.

What are the four APRN roles? Nurse practitioners, certified nurse midwives (CNMs), clinical nurse specialists (CNSs), and certified registered nurse anesthetists (CRNAs). They differ in specialization and scope of duties.

What degree do you need to become a nurse practitioner? An MSN or a DNP. Most programs require a BSN for admission, though some accept associate degrees or a related health-science bachelor's through bridge tracks.

Do NPs choose a specialty before or after licensure? Before. NPs select a population focus (such as family, pediatric, psychiatric, or adult-gerontology) during their graduate program. Other APRNs, like CNSs, can choose a focus after they begin practicing.

How do you get certified as an NP? Complete your MSN or DNP, then pass a national certification exam through a board such as AANPCB or the ANCC, then apply for state APRN licensure and recertify on schedule.

How much do nurse practitioners earn? The median NP wage was $129,210 in May 2024, and NP employment is projected to grow 40 percent from 2024 to 2034 (BLS).