North Carolina Nurse Practitioner Licensure Steps - 2025

Nurse Practitioner Licensure Requirements in North Carolina

Demand for primary care and mental‑health services continues to surge across North Carolina—especially in the state’s Health Professional Shortage Areas (HPSAs). At the same time, policy makers are debating full practice authority for advanced practice registered nurses. This guide distills the latest statutes, fees, and application portals into a single roadmap so candidates can navigate licensure efficiently and bring advanced care where it’s needed most.

At‑a‑glance timeline: motivated RNs can progress from BSN completion to active NP approval in as little as six months with strategic planning.

Secure an Active North Carolina (or Compact) RN License

• Apply by Examination: Start an online application through the NCBON RN Examination portal ($75) and register for the NCLEX via Pearson VUE ($200).
• Apply by Endorsement: Already licensed elsewhere? Use NCBON’s endorsement application ( $150) and send verification through Nursys ( $30).
• Compact Advantage: North Carolina participates in the Nurse Licensure Compact; a multistate license lets you practice immediately for up to 90 days while you establish residency.
• Fingerprinting: Download step‑by‑step Live‑Scan instructions from NCBON’s CBC page before scheduling your prints.
• Manage paperwork: All forms, uploads, and fee payments flow through the secure Nurse Portal.

Tip: Complete the criminal background check first—results can take four weeks during peak testing seasons.

Graduate From an Accredited NP Program

North Carolina law requires an ACEN‑ or CCNE‑accredited master’s, post‑master’s certificate, or DNP that aligns with your intended population focus.

• Confirm program accreditation through the CCNE search tool or ACEN database.
• Distance learners: Verify North Carolina clinical placement eligibility with your school’s compliance office before enrolling.
• Ask whether the curriculum includes rural clinical rotations; many campuses partner with Area Health Education Centers (AHECs) and NC AHEC sites in underserved counties.

Earn and Maintain National Certification

State approval hinges on an active credential from a Board‑recognized certifier:

• ANCC
• AANP
• PNCB
• NCC
• ONCC
• NBCHPN

Timing tip: Schedule the certification exam to finish before your final semester ends; NCBON cannot process your approval without the credential ID.

Register as an NP and Obtain Approval to Practice (ATP)

1. NP Registration – Submit the $25 registration via the Nurse Portal. This establishes your APRN record but does not authorize clinical care.
2. Approval to Practice – Complete the ATP form inside the portal: upload your collaborative practice agreement, malpractice policy, and list each supervising physician ($100 per physician; $20 if services are volunteer).
3. Download the Board’s ATP checklist to ensure no attachments are missed.
4. Optional endorsement: track license verification status in real time through Nursys QuickConfirm.

Do not treat patients until the Board emails your approval certificate—early practice is considered unlicensed and carries civil penalties.

Add Prescriptive Authority

• Apply online for a DEA number through the DEA Diversion Registration portal.
• Enroll in the NC Controlled Substances Reporting System (CSRS) within 30 days of your first Schedule II‑V prescription.
• Ensure your collaborative practice agreement spells out prescribing limits and quality‑improvement meeting frequency (minimum twice per year).
• Review NC Medicaid’s Telehealth Policy 1‑H for equal reimbursement on virtual visits.