Becoming an Advanced Practice Registered Nurse (APRN) requires earning an RN license, completing a graduate nursing program, passing a national certification exam, and obtaining state licensure. The full path from your first nursing degree to practicing as an APRN typically takes six to eight years, though the timeline varies based on the role you choose and whether you pursue a master’s or doctoral degree.
The Four APRN Roles
APRN is an umbrella term covering four distinct roles, and the one you choose shapes every step that follows, from the graduate program you apply to, to the certification exam you take, to what your daily work looks like.
- Certified Nurse Practitioner (CNP): The most common path. NPs diagnose and treat patients, prescribe medications, and often serve as primary care providers. You’ll specialize in a population focus such as family, adult-gerontology, pediatrics, psychiatric-mental health, neonatal, or women’s health.
- Certified Registered Nurse Anesthetist (CRNA): CRNAs administer anesthesia for surgeries and procedures. This role requires a doctoral degree and is one of the highest-paid nursing specialties.
- Certified Nurse Midwife (CNM): CNMs provide reproductive and prenatal care, deliver babies, and manage women’s health across the lifespan.
- Clinical Nurse Specialist (CNS): CNSs work within hospital systems to improve patient outcomes, develop care protocols, and mentor other nurses. They specialize in areas like adult-gerontology or neonatal acute care.
Step 1: Earn Your BSN and RN License
Every APRN path starts with becoming a registered nurse. You’ll need a Bachelor of Science in Nursing (BSN), which takes four years as a traditional undergraduate student. If you already hold a non-nursing bachelor’s degree, accelerated BSN programs can get you there in 12 to 18 months. After graduating, you must pass the NCLEX-RN exam to earn your RN license.
Most graduate programs also expect at least one to two years of clinical nursing experience before admission. CRNA programs are particularly competitive and often prefer candidates with intensive care unit experience. This bedside time isn’t just an admissions checkbox; it builds the clinical judgment you’ll need to practice independently later.
Step 2: Complete a Graduate Nursing Program
APRN practice requires at minimum a Master of Science in Nursing (MSN). A growing number of programs now offer the Doctor of Nursing Practice (DNP) as the entry-level degree, and CRNA programs have fully transitioned to requiring a doctorate. You can also earn your MSN first and bridge to a DNP later through MSN-to-DNP programs designed for working professionals.
MSN programs average about 48 credit hours and typically take two to three years of full-time study. Tuition at public universities averages around $16,600 for in-state students and $34,300 for out-of-state students. Private universities average about $34,300 regardless of residency. Costs range widely: in-state public programs can run as low as $2,600 total, while the most expensive nonresident programs exceed $95,000.
Your program must be accredited by one of the recognized bodies (CCNE, ACEN, or CNEA) for your degree to count toward licensure and certification. During the program, you’ll complete a substantial amount of hands-on patient care. Nurse practitioner programs require a minimum of 750 direct patient care clinical hours. DNP programs require at least 1,000 total post-baccalaureate clinical hours, with 750 of those being direct patient care and the remaining hours potentially applied toward a scholarly DNP project.
Step 3: Pass a National Certification Exam
After graduating, you need to pass a certification exam specific to your role and population focus. The certifying body depends on your specialty:
- Nurse practitioners most commonly certify through the American Academy of Nurse Practitioners Certification Board (AANPCB) or the American Nurses Credentialing Center (ANCC). AANPCB offers exams for family, adult-gerontology primary care, and psychiatric-mental health NPs. ANCC covers those plus women’s health and acute care tracks. Pediatric NPs certify through the Pediatric Nursing Certification Board, and neonatal NPs through the National Certification Corporation.
- CRNAs certify through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).
- CNMs certify through the American Midwifery Certification Board (AMCB).
- CNSs certify through ANCC or the American Association of Critical-Care Nurses (AACN), depending on their specialty.
These are rigorous exams, and your graduate program curriculum will be aligned with the content. Most candidates spend several weeks in focused exam preparation after finishing their program.
Step 4: Apply for State APRN Licensure
National certification alone doesn’t authorize you to practice. You must also apply for an APRN license (or certificate, depending on the state) through your state’s board of nursing. While requirements vary by state, the process generally includes submitting proof of a current RN license in good standing, official graduate transcripts sent directly from your university, verification of national certification sent from your certifying body, background check documentation, and application fees.
Fees are relatively modest. In New Jersey, for example, the application fee is $100 plus a certificate fee of $80 to $160 depending on your RN license expiration date. Most states fall in a similar range. The processing timeline varies, but expect several weeks between submitting your application and receiving your APRN license.
Step 5: Obtain Prescriptive Authority
If your role involves prescribing medications, you’ll need a few additional registrations. A National Provider Identifier (NPI) number, issued by the Centers for Medicare and Medicaid Services, is required for billing and prescribing. If you’ll prescribe controlled substances, you also need a DEA registration, obtained through DEA Form 224. Some states grant prescriptive authority automatically with your APRN license, while others require a separate application or a collaborative agreement with a physician.
Practice Authority Varies by State
Where you practice significantly affects how independently you can work. As of February 2025, 21 states and territories grant nurse practitioners full independent practice and prescriptive authority, meaning no physician oversight is required. These include Alaska, Arizona, Hawaii, Idaho, Iowa, Montana, Oregon, Washington, and others.
Seven additional states allow full independent practice but impose some restrictions on prescribing. Colorado, Massachusetts, New Mexico, and West Virginia, for example, require a transition period before you can prescribe independently. Kentucky and New Jersey require a physician relationship specifically for prescribing, even though practice itself is independent. The remaining states require some form of physician collaboration or supervision for both practice and prescribing.
If practicing independently is important to you, factor state practice laws into your decisions about where to work, or even where to attend school and build clinical connections.
Keeping Your Certification Active
APRN certification isn’t permanent. Through the AANPCB, for example, certification renews every five years. You’ll need at least 100 contact hours of advanced continuing education during each five-year cycle, with 25 of those hours specifically in pharmacology. Other certifying boards have similar requirements. Staying current on continuing education is a professional responsibility that begins the moment you’re certified, so it’s worth building a habit of tracking your hours from the start.
Total Timeline and Cost at a Glance
For most people, the journey looks like this: four years for a BSN, one to two years of clinical RN experience, then two to three years for an MSN (or three to four for a DNP). That puts the total timeline at roughly seven to nine years from your first day of nursing school to practicing as an APRN. If you already have an RN license and clinical experience, the remaining stretch is the two to four years of graduate school plus a few months for certification and licensure.
Total graduate tuition ranges from under $3,000 at the most affordable in-state public programs to over $50,000 at private or out-of-state institutions. Many APRNs work as RNs while completing their graduate programs part-time, which extends the timeline but offsets the financial burden. Loan repayment programs and scholarships specifically for advanced practice nurses are also widely available, particularly for those willing to practice in underserved areas.