A locum nurse practitioner is an NP who works temporary assignments at healthcare facilities instead of holding a permanent position. The term comes from the Latin “locum tenens,” meaning “one holding a place,” and that’s exactly the role: filling in where coverage is needed, whether that’s a rural clinic short on staff or a hospital system covering for an NP on maternity leave. Locum NPs are considered independent contractors in most cases, and the work has grown rapidly as healthcare organizations struggle with provider shortages.
How Locum NP Work Differs From Permanent Roles
A permanently employed NP works at one facility, builds long-term patient relationships, climbs an internal career ladder, and receives employer benefits like health insurance and paid time off. A locum NP does none of that in the traditional sense. Instead, you take assignments through staffing agencies (or occasionally through direct contracts with facilities), work for a set period, and move on to the next assignment or take time off.
Assignments vary widely. Some last a few weeks to cover a provider’s vacation. Others stretch six months or longer at facilities dealing with chronic staffing gaps. You might work in a large urban hospital system one quarter and a small community clinic the next. The settings span primary care, urgent care, emergency departments, psychiatric facilities, and specialty practices.
Because locum NPs are typically classified as independent contractors, they receive a 1099-NEC tax form rather than a W-2. That means no automatic tax withholding, no employer-sponsored retirement match, and more responsibility for managing your own finances. Some agencies do offer W-2 arrangements with benefits, but the independent contractor model is more common.
Pay and Financial Considerations
Locum NPs generally out-earn their permanently employed counterparts. The average total compensation for nurse practitioners reached $133,000 in 2024, but independent contractors and per-diem clinicians often exceed that figure because facilities pay a premium for temporary staffing flexibility. Hourly NPs have historically earned more than salaried ones, though that gap has narrowed recently.
Beyond the higher hourly rate, locum work comes with financial perks that aren’t immediately obvious. Agencies typically cover housing and travel costs, either by arranging accommodations directly or providing a stipend. Housing stipends vary by location. In lower-cost states like Florida or Kentucky, agencies may offer around $2,000 per month, while agency-booked extended-stay hotels in pricier markets can run $4,600 per month or more. If the agency books housing for you, they generally cover it even during your scheduled weeks off. With a stipend, some agencies reduce the payment for weeks you aren’t working.
The tax picture is more complex but can work in your favor. As an independent contractor, you can deduct business expenses that permanent employees cannot: flights, rental cars, lodging not reimbursed by the agency, work meals, licensing fees, continuing education, professional dues, scrubs, medical equipment, and even a portion of your phone and home office costs. Health insurance premiums are deductible as a business expense. If you pay for your own malpractice coverage, those premiums are deductible too. The standard mileage deduction for self-employed work is 70 cents per mile in 2026.
Licensing and Credentialing
Before you can start a locum assignment, you need to be licensed in the state where you’ll practice and credentialed at the specific facility. The Nurse Licensure Compact, managed by the National Council of State Boards of Nursing, allows nurses to practice across all member states with a single license, which significantly reduces the paperwork for locum NPs who move between assignments in different states. If your assignment is in a non-compact state, you’ll need to obtain that state’s license separately.
Credentialing for locum practitioners typically takes one to four weeks, considerably faster than the 30 to 90 days hospitals require for permanent hires. Staffing agencies usually handle the credentialing paperwork on your behalf, verifying your education, certifications, work history, and background. Still, repeated onboarding is one of the consistent downsides of locum work. Every new facility means learning a different electronic health record system, new protocols, and new team dynamics.
Malpractice Insurance
Most locum staffing agencies provide malpractice coverage as part of the assignment, so you don’t need to purchase your own policy. These are typically claims-made policies, meaning they cover incidents that occur and are reported while the policy is active. Because agencies renew their policies continuously, coverage extends back to the policy’s origination date and applies to all current and past locum providers under that agency. This eliminates the need for individual “tail” policies (extended coverage after a policy ends) that providers in permanent roles sometimes have to buy themselves.
Some NPs prefer to carry their own occurrence-based malpractice policy as an extra layer of protection. Occurrence policies cover any incident that happens during the policy period regardless of when a claim is filed, so no tail coverage is needed.
Why NPs Choose Locum Work
Schedule flexibility is the most commonly cited reason. Instead of negotiating PTO with a manager, locum NPs build time off directly into their calendar. You choose when to work, how long each assignment lasts, and when to take breaks. One NP described taking four to six months off to hike the Appalachian Trail and returning to clinical work afterward, something no traditional position would accommodate. Another noted it was the first time in her entire career she had both Thanksgiving and Christmas week off.
Geographic freedom is the other major draw. Assignments exist across rural and urban settings, coastal and mountain regions, large systems and small clinics. For NPs who want to experience different parts of the country, or who want to test out a new city before committing to a permanent move, locum work provides that without a gap in clinical practice.
Professional variety and reduced burnout round out the benefits. Working in different settings with different patient populations keeps the work from becoming monotonous, and the ability to take extended breaks between assignments provides recovery time that permanent roles rarely allow.
The Tradeoffs
Locum work isn’t without real downsides. You lose continuity with patients, which can be frustrating if building long-term relationships is important to your sense of professional fulfillment. Team relationships are temporary by definition. There’s no institutional advancement, no seniority, no building equity within an organization over years.
There can be gaps between assignments, especially if you’re selective about location or specialty. During those gaps, you have no income unless you’ve planned for it. And while agencies handle many logistics, you’re still responsible for your own health insurance, retirement savings, and quarterly tax payments as an independent contractor.
Some NPs also find the constant adjustment exhausting. Every new facility means learning where supplies are kept, how the team communicates, and what the local patient population looks like. For some, that novelty is energizing. For others, it wears thin.
Market Demand for Locum NPs
The locum tenens market overall reached an estimated $9.6 billion in 2025 and is projected to hit $9.9 billion by 2026. Physician shortages are expected to worsen through 2037, with steep deficits in family medicine and several surgical specialties. That shortage drives demand for nurse practitioners to fill gaps, particularly in primary care, urgent care, and behavioral health settings.
Nurse practitioners are among the fastest-growing healthcare occupations in the country, with job growth projected at 40.9% through 2034 according to the Bureau of Labor Statistics. Within the locum tenens workforce specifically, advanced practice providers like NPs are playing an increasingly large role as health systems look beyond physicians to meet patient demand. For NPs considering locum work, the supply-demand equation currently works strongly in their favor.