How to become a nurse practitioner

1. 1Earn a Bachelor of Science in Nursing (BSN)

   Time: 4 yearsCost: Undergraduate tuitionSources 1, 8

   Most NP programs want applicants with a BSN, which takes about four years and combines science courses with clinical rotations in hospitals and clinics. Nurses who start with an associate degree can use RN-to-BSN programs or RN-to-MSN bridge tracks offered by some schools. People with a bachelor's in another field can choose accelerated or direct-entry programs that prepare them for the RN exam on the way to graduate study.

2. 2Pass the NCLEX-RN and get your RN license

   Time: A few months after graduationCost: $200 NCLEX fee ($350 from Feb. 1, 2027) plus state license feesSources 2, 11

   The NCLEX-RN is the national licensing exam for registered nurses, developed by the National Council of State Boards of Nursing. Registration costs $200, rising to $350 in February 2027. After you pass and meet your state board's other requirements, such as a background check, you are licensed as an RN. You need an active RN license before and during NP school and to sit for NP certification.

3. 3Work as a registered nurse

   Time: Often 1 to 3 yearsSources 8

   Not every NP program requires RN experience, but many prefer it, and the clinical judgment you build at the bedside makes NP training easier to absorb. Choose experience that fits the NP role you want: medical-surgical or primary care nursing for family practice, ICU or emergency work for acute care, behavioral health units for psychiatric NP. Many nurses keep working part time while they study, and some employers help pay graduate tuition.

4. 4Complete an accredited NP program (MSN or DNP)

   Time: 18 to 24 months full time (master's); longer for a DNPCost: Graduate tuition; median federal debt $45,241 (master's) to $74,168 (doctoral)Sources 5, 8, 9

   You choose a population focus at admission, most often family. The core includes three separate graduate courses in advanced physiology and pathophysiology, advanced health assessment and advanced pharmacology, followed by role courses and supervised clinical hours; ANCC requires at least 500 for FNP certification. Make sure the program is accredited by CCNE, ACEN or NLN CNEA. Many programs offer online coursework, but you still need clinical placements with preceptors.

5. 5Pass a national NP certification exam

   Time: Within a few months of graduatingCost: $240-$315 (NPCB) or $295-$395 (ANCC)Sources 4, 12, 5, 1

   Family NPs choose between two boards. NPCB's Family Nurse Practitioner exam has 150 multiple-choice questions (135 scored) in 3 hours, and once approved you have 120 days to test at a Prometric center. ANCC's FNP-BC exam has 175 questions, 150 of them scored, with 3.5 hours to finish, and the credential is valid for five years. Other population foci, such as psychiatric-mental health or pediatrics, have their own exams. Most states require national certification for an NP license.

6. 6Get your state APRN license and prescribing credentials

   Time: A few weeks to a few monthsCost: State license feesSources 1, 6, 10

   Apply to your state board of nursing for APRN or NP licensure or recognition, using your RN license, transcript and certification. States differ on what comes next. In full practice states you can work independently once licensed, while reduced and restricted practice states require a collaborative agreement or supervision with a physician. You will also register to prescribe, including federal registration for controlled substances where your state allows it. Use the CareerOneStop License Finder to reach your board.

Programs, tuition and graduates’ earnings

U.S. Department of Education, College Scorecard (most recent cohorts, released 2026-10-15). Scorecard groups programs by 4-digit field, so a row can include related programs. Tuition is the median published undergraduate tuition and fees of the colleges offering the program (shown only for undergraduate credentials); debt is the median of programs’ median federal loan debt at completion; earnings are the national median for the field and credential four years after completion.

Requirements differ by state. Check your state’s rules in the CareerOneStop License Finder (U.S. Department of Labor) before you enroll.

Diagnostic reasoning

You are often the only clinician in the room, so you must sort common complaints from the dangerous ones and decide who needs a referral today.

Pharmacology knowledge

Safe prescribing means weighing doses, interactions and side effects, especially for older patients on many medications.

Patient education

Managing diabetes or hypertension depends on what patients do at home, so explaining the plan clearly affects outcomes.

Efficient documentation

Clinics book short visits back to back, and charting, orders and messages have to keep pace.

Knowing your limits

Recognizing when a case needs a physician or specialist protects patients and is part of every collaborative agreement.

O*NET 31.0 rates these skills as most important for the occupation: reading comprehension, active listening, critical thinking, writing, speaking.

Training cost

$45.5K–$74.6K

Before financial aid

Time

6 to 8 years

Typical path

Median pay

$132,300

All US jobs: $50,980

Payback once qualified

Under 1 year

Pay above the all-jobs median vs. cost

Graduate NP education and certification only. Official tuition varies too widely by school to average, so we use College Scorecard's median federal loan debt as a guide. Low: median debt for nursing master's graduates, $45,241, plus the NPCB certification exam at the AANP member price of $240. High: median debt for nursing doctoral graduates, $74,168, plus the ANCC FNP-BC exam at the non-member price of $395. Debt reflects what graduates borrowed, not full tuition. Not included: the BSN, NCLEX and state license fees, books, and income lost while studying.

Rough guide only: ignores taxes, aid, interest and earnings given up during training. How we calculate it.

• Lead APRN, clinical director or practice owner

  Experienced NPs can manage NP and PA teams, direct clinical programs, or open their own practice in states that allow full practice authority.

• Nurse educator or researcher$82,250 median

  NPs with a DNP or PhD teach in nursing programs and precept students; a PhD is the usual route into research careers.

• Nurse midwife$134,040 median

  Requires a separate accredited nurse-midwifery graduate program or post-graduate certificate and the national midwifery certification exam.

• Nurse anesthetist (CRNA)$236,590 median

  Requires critical care RN experience and a separate doctoral nurse anesthesia program; NP training does not substitute for it.