Nurse Practitioner: Nursing Specialties Breakdown

  • Becoming a nurse practitioner is a multi-step process, including education, clinical experience, and licensure.
  • There are several specialties and environments that NPs can work in, ranging from family nurse practitioner to women’s health nurse practitioner.  
  • NPs typically pursue additional training or certification. This can come from organizations like the American Nurses Credentialing Center or the AMerican Association of Nurse Practitioners.

Tracey Long


March 26, 2024
Simmons University

Are you interested in becoming a Nurse Practitioner? Maybe you are a working Registered Nurse and are looking to expand your formal education by getting a master’s degree, or you’re tired of coming home with sputum and feces on your scrubs and are hoping to work in a clean office.  

Maybe you’re not even a registered nurse yet and just looking to understand your options. Either way, it’s all explained here in this blog.  

What is Required to Become a Nurse Practitioner? 

Becoming a nurse practitioner (NP) involves multiple steps that include education, clinical experience, and licensure. Here are the usual steps involved with becoming a nurse practitioner:  


Educational Requirements 

Complete an accredited Bachelor of Science in Nursing degree program to become eligible as a candidate for nurse practitioner schooling. Some nursing programs accept associate degree in nursing (ADN) graduates but require them to complete a bridge program before earning their BSN degree. Achieve Registered Nurse Status by passing the NCLEX-RN examination. 


Clinical Experience Requirements 

Most Nurse Practitioner programs require applicants to have at least some clinical experience prior to application for the master’s program. This experience may range anywhere from one to several years, depending on the program chosen.  


Select Your Nurse Practitioner Specialty 

NPs may specialize in various areas, including family medicine, pediatrics, adult gerontology, acute care, and mental health. Decide your area of specialization according to your interests and career objectives. 


NP Program Completion 

Enroll in either a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) program offering nurse practitioner tracks. DNP programs are becoming more mainstream and may soon be the preferred degree for NPs. To complete NP Education successfully, finish an approved NP program successfully within 2 to 4 years, depending on its complexity and your prior education background.  



After successfully graduating from your NP program, if desired, you’ll need to pass a national certification examination in your chosen specialty area for certification purposes. The reason it is “if desired” is that not all positions or states require board certification, although it is generally highly encouraged. Certification bodies such as the American Nurses Credentialing Center (ANCC) or the American Academy of Nurse Practitioners Certification Board (AANPCB) typically administer certification exams.  


Obtain State Licensure 

Apply for state licensure as an Advanced Practice Registered Nurse or Nurse Practitioner. Regulations and requirements may differ by state, so make sure you are familiar with your State Board of Nursing requirements. Education, clinical experience, and ongoing professional development are required to succeed in any nursing position. 

What Specialties are Available for Nurse Practitioners? 

Picture a six-floor building that represents the nursing profession. The first floor is the position and limited scope of practice of a certified nursing assistant. The second floor represents a licensed practical nurse or licensed vocational nurse in some states.  

Each room on that floor represents a potential area in which the LPN/LVN may work. The third floor is for a Registered Nurse and has many more rooms within that floor representing hospital nursing, public health nursing, school nursing, home health nursing, etc.  

Within the hospital room are dozens more rooms representing the variety of hospital settings and units where a RN works, including a medical-surgical nursing unit to critical care, pediatrics, ICU, emergency nursing, obstetrics, labor and delivery, and much more.  

Continuing upward on the nursing building, now on the fourth floor, are nurse practitioners. Within the floor for nurse practitioners are dozens more rooms where nurse practitioners can work. Each floor represents additional educational training required to advance to the next level. 

The nurse on each floor can perform duties from the prior nursing floors within their nursing training. For example, a registered nurse can perform all duties of an LPN or CNA. Climbing to the next subsequent floor requires additional training but also is rewarded by higher pay.  

Nurse practitioners (NPs) work in various specialties and environments. Their scope of practice may depend upon factors like education, certification status, and state regulations.  

Here are a few common specialty areas in which nurse practitioners work:  

  • Family Nurse Practitioner (FNP): FNPs specialize in primary health care for individuals and families across their lifespan, from babies through seniors.  
  • Adult-Gerontology Nurse Practitioner (AGNP): AGNPs specialize in caring for adults and the elderly. They often specialize in family practice clinics or primary care settings as well as healthcare facilities.  
  • Geriatric Nurse Practitioner (NP): PNPs specialize in caring for elderly adults in settings like internal medicine or long-term care facilities. They specialize in chronic conditions of the elderly.  
  • Pediatric Nurse Practitioner (PNP): These PNPs focus their efforts exclusively on taking care of young patients under 18.  
  • Women’s Health Nurse Practitioner (WHNP): Women’s Health Nurse Practitioners specialize in women’s healthcare needs, such as gynecological and obstetric services. They may work at clinics, hospitals, or schools. Women’s health nurse practitioners (WHNPs) usually work in clinics, family planning centers, or labor and delivery units. 
  • Psychiatric-Mental Health Nurse Practitioner (PMHNP): PMHNPs specialize in mental health and psychiatric services to all age groups of patients.  


Within these categories are unique sub-specialties such as acute and emergency care and hospital-based nurse practitioners. Although a common setting for nurse practitioners is to work in a clinic or office setting, those who choose to become acute care Nurse Practitioner specialists may still work in a hospital unit such as ICU/CCU/NICU and prescribe and write orders for acute care.  

Others may work in rehabilitation facilities where they make rounds and write orders for continuing care of in-patients. So yes, there still may be feces and sputum involved! Once a nurse, always a nurse!   

What Additional Training is Required? 

After you graduate from an accredited nurse practitioner program, there is still an opportunity for lifelong learning. One advantage of being in the medical field is that there is always new information to learn to expand your skills and competence.  

Once awarded either an MSN or DNP degree as a nurse practitioner (NP), nurse practitioners typically pursue additional training, certifications, or continuing education to specialize in one particular patient population or clinical area of specialty. Training requirements may depend upon an NP’s chosen specialty as well as state regulations.  

Here are a few common strategies NPs can utilize when seeking additional training:  


Nurse practitioners often pursue specialty certification through organizations like the American Nurses Credentialing Center (ANCC) or the American Association of Nurse Practitioners (AANP). Certification exams assess NP knowledge and clinical skills related to their specialty, such as family practice, pediatrics, or mental health. 

Clinical Residencies or Fellowships 

Some NPs choose to participate in postgraduate residencies or fellowships specific to their area of specialization after graduating from nursing school. These programs provide structured clinical experiences and mentoring to build expertise while continuing education is required of them in order to maintain certification/licensure status.  

Advanced Practice Registered Nurse (APRN) Collaborative Agreements 

In certain states, advanced practice registered nurses (NPs) must collaborate with physicians, sign an official practice agreement, or work under certain levels of supervision in order to be licensed as advanced practice registered nurses (APRNs).  

Many Nurse Practitioners (NPs) seek advice and direction from state nursing boards, specialty organizations, and colleagues in order to meet all necessary training and certification requirements for their specialty area of interest. Continuing education and professional development play an essential part in staying abreast of recent healthcare advances and offering quality patient care, just as was required as a Registered Nurse.  

How are a Nurse Practitioner and Physician Assistant Compared? 

When people ask if a nurse practitioner is like a Physician Assistant (PA) it’s important to know that the Physician Assistant is not even in the same “building” as a nurse in our building analogy. They may actually do similar activities, but the PA track is a separate building with only 2 floors.

The first floor is the requirement to have a bachelor’s degree in anything with required prerequisites in the sciences such as anatomy and biology. The second floor is the master’s degree in a Physician Assistant program, which is generally two years.  

A PA is not a nurse and does not have the same clinical experience as an RN. Occasionally, an RN will go into a PA program rather than an NP program, as PAs are often used in surgery and are trained more in the medical model than the nursing model. What does that mean? The nursing model is a holistic approach combining the art and science of nursing to help care for patients, compared to the medical model, which is often illness-based and focuses on Western medical treatments. 

Two huge differences are the scope of practice and autonomy in their work. A Nurse Practitioner works under the authorization of the State Board of Nursing with a specific legal scope of practice and, in many states, can practice with autonomy. That means that in many states, they do not have to work “under the license” of a medical doctor.

Like any nurse, they still must practice within their training and legal scope of practice of that state. In contrast, a Physician Assistant must always work under the direction of a physician in any state and has a limited scope of practice beneath the listed Physician.  

Another shorter comparison in our building analogy is where the medical assistant or even a phlebotomist is on the nursing ladder. The easy answer is that neither is even in the nursing building. They are both only on a one-rung step.

Many times that leads them to get the fundamental knowledge and clinical experience they need to apply to enter the nursing building or nursing school. That may even be you who are reading this blog and trying to decide what your options and opportunities may be. Remember, not only does each step up require more education, but it will also come with higher pay.  

What are Typical Activities for Nurse Practitioners?  

The Nurse Practitioner will continue to use the nursing process as a fundamental clinical process of thinking about patients and health concerns. Nurse Practitioners (NPs) are advanced practice registered nurses trained and authorized to offer many health services.  

Nurse Practitioners play an invaluable role in expanding access to healthcare, particularly in regions with an undersupply of primary care providers, often acting as primary providers themselves by offering comprehensive medical services across an age spectrum. The NP will expand on those fundamental RN skills by performing these duties.  

Their specific duties can vary depending on their specialty, practice setting, and state regulations, but here are some typical duties of nurse practitioners: 

  • Assessment and Diagnosis: NPs continue to use the nursing process by taking medical histories and completing physical exams. As a prescriber, they will expand on these activities by ordering and interpreting diagnostic tests. 
  • Treatment Planning: Similar to creating a nursing care plan, a NP will create a comprehensive medical treatment plan for an acute or chronic problem. This may include prescribing medications and therapies. 
  • Patient Education: NPs use their RN skills by educating patients and their families about medical conditions, treatment options, illness prevention, and health promotion. 
  • Chronic Disease Management: NPs manage chronic health conditions, such as diabetes, hypertension, COPD, and asthma. As a generalist, they will work in primary care by providing ongoing care, monitoring, and adjustments to treatment plans. 
  • Acute Care: NPs can provide immediate care for common acute illnesses and injuries, such as infections, minor injuries, and respiratory conditions. 
  • Preventive Care: They teach health promotion and disease prevention by performing routine screenings and vaccinations. 
  • Prescribing Medications: One huge difference between the scope of practice of an RN and NP is that the NP can prescribe medications, including initiating, adjusting, and discontinuing treatments. The RN is trained to follow those orders, but the NP can write the medication orders.  
  • Specialized Procedures: Some NPs are trained to perform specific medical procedures or interventions within their area of specialization, such as suturing or small emergency procedures. 
  • Collaboration: NPs work in collaboration with physicians and other healthcare professionals, consulting with them on complex cases or referring patients for specialized care. 
  • Hospital Rounds: If an NP works in a hospital setting, they may round on patients, order and interpret tests, prescribe medications, and collaborate with the healthcare team. 
  • Women’s Health: With specialized training, an NP may deliver babies and provide prenatal and postpartum care, gynecological exams, and family planning services. 
  • Mental Health Services: Psychiatric-mental health NPs provide mental health assessments, therapy, and medication management for patients with mental health conditions. Currently, they are the highest in demand and receive a higher pay scale compared to other general nurse practitioners.  
  • Pediatric Care: Pediatric NPs provide care for children, including well-child visits and vaccinations. 
  • Geriatric Care: NPs specializing in gerontology focus on the health conditions of elderly patients and promoting healthy aging. 
  • Palliative and Hospice Care: Some NPs provide care for patients with serious illnesses, helping manage symptoms and providing support for end-of-life care. 
  • Community Health: NPs may work in community health clinics, providing care to underserved populations, performing health assessments, and managing public health initiatives. 
  • Research and Education: Not all NPs work at the bedside as RN. Some NPs may engage in research, teach in academic institutions, or provide education and training to other healthcare professionals. 

The Bottom Line

Nurse Practitioners (NPs) possess remarkable versatility, adapting their expertise to accommodate diverse healthcare settings and patient populations, making them invaluable assets on healthcare teams across all settings.  

There are a variety of financial benefits to becoming a nurse practitioner. Scope of practice requirements may differ by state as NPs navigate state regulations to achieve certification for their chosen specialty area.  

Remember, a Nurse Practitioner is not “better than” an RN but rather a specialized RN with an advanced degree, scope of practice, and liabilities. Similarly, an RN is not “better than” a certified nursing assistant. Each member has a unique role and is very needed in the healthcare team.  

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