Whether you are currently a registered nurse who dreams of running their own practice one day or you are a qualified nurse practitioner who is ready to be their own boss, making the decision to start your own nurse practitioner business is not one that should be taken lightly. 

From making sure you have the right qualifications, to filing all the relevant paperwork, to determining your staffing needs, there is so much that you need to do before you can open your business to the public. 

That being said, if you are determined to act as a primary care provider for your chosen community (and the state allows it), there is no reason why you can’t run a successful nurse practitioner practice. 

Not sure where to start? 

Don’t worry. The below guide will tell you everything you need to know, and do, to start up your own practice. 

Become a qualified nurse practitioner

If you are not already an NP, then this should be your first step, as you are not allowed to practice independently without an advanced-practice nursing qualification such as a DNP degree. 

A nurse practitioner has the ability to assess, diagnose, and treat patients with a wide range of illnesses but often specializes in a specific field such as mental health or pediatrics.

Common tasks for a nurse practitioner include:

  • Conducting check-ups 
  • Refilling prescriptions 
  • Requesting tests 
  • Creating treatment plans 
  • Referring patients to the hospital 

If you want to become a nurse practitioner, you first need to earn a BSN degree and then obtain an RN license. If you are already working as a registered nurse, you are likely to already have both of these certifications. 

Your next step is to decide whether you want to pursue an MSN degree (a master’s) or a DNP degree (a doctorate). 

Which one you choose to undertake is completely up to you, although it is worth noting that a DNP degree is one of the most advanced nursing qualifications that you can have (alongside a PhD in Nursing) and will provide you with an in-depth knowledge of clinical practice as well as a focus on leadership in nursing. 

When choosing your DNP degree program, you should choose a program that directly relates to the field of nursing that you wish to work in or that you want your own practice to specialize in. For example, if you want to focus on family nursing, you should opt for a DNP degree that will result in your becoming a qualified Family Nurse Practitioner. 

If you are not sure what DNP degree program is right for you, then you may want to spend a little more time pursuing a specialist area of nursing as an RN before committing to an advanced nursing degree. This could be mental health, pediatrics, gerontology, or neonatal care; just be sure to focus your efforts on an area of nursing that you are passionate about. 

Research the law 

As briefly mentioned above, some states allow nurse practitioners to practice independently, whereas others dictate that you have to work under a physician. 

There are currently 22 states that have NP practice autonomy, and these are:

  • Alaska 
  • Colorado
  • Arizona 
  • Connecticut
  • Hawaii
  • Idaho
  • Iowa
  • Maine 
  • Maryland 
  • Minnesota 
  • Montana 
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico 
  • North Dakota
  • Oregon 
  • Rhode Island 
  • South Dakota
  • Vermont 
  • Washington
  • Wyoming 

That being said, each of these states has their own individual requirements as to what you can and can’t do within your own practice, so you should ensure you contact the Board of Nursing for the state in which you will be practising to review your state’s laws. 

There are then 16 states that are known as reduced practice states, which means you can practice independently after a certain number of hours working under another healthcare provider. These states are:

  • Alabama 
  • Arkansas
  • Delaware
  • Illinois 
  • Indiana 
  • Kansas
  • Kentucky 
  • Louisiana
  • Mississippi 
  • New Jersey
  • New York
  • Ohio
  • Pennsylvania 
  • Utah 
  • West Virginia 
  • Wisconsin

Finally, there are 12 states that are restricted practice states and require nurse practitioners to work under a physician. These states are:

  • California 
  • Florida
  • Georgia
  • Massachusetts 
  • Michigan
  • Missouri
  • North Carolina
  • Oklahoma 
  • South Carolina 
  • Tennessee
  • Texas 
  • Virginia 

That being said, due to a national shortage of physicians and nurse practitioners in the United States, some states may choose to relax their laws in the not too distant future, so always check the most recent review of your preferred state’s laws before making a decision about opening your own practice. 

File any relevant paperwork 

If you have chosen to complete a DNP degree before opening your own nurse practitioner practice, then this advanced nursing qualification will have prepared you for the administration side of being a nurse practitioner. If not, getting your head around healthcare policies and legal regulations may take some getting used to, but you’ll get there in the end.

As you are opening a new business, you will be required to obtain certain permits and licenses. You will also need to apply for an NPI, National Provider Identifier number, which is issued to healthcare providers in the United States by Centers for Medicare and Medicaid Services. This application process can be a bit daunting, so be sure to visit their website before starting your application to ensure that you know what exactly it is that you need to do and the information you need to provide.  

During this stage, you should also determine insurance reimbursements as most of your patients will not want to pay out of pocket for insurance. You need to decide:

  • Which insurances you are going to accept 
  • What the compensation is 
  • What specific services are covered

Think about the logistics 

Once you have established the extent to which you can practice independently in your state, you can now turn your thoughts to the logistics of running your own nurse practitioner practice. This includes key elements such as staffing, budgeting, and choosing the exact location of your practice. 

If you have already created a business plan for your new nurse practitioner business, then this step shouldn’t be too difficult. However, if you haven’t, now might be the best time for you to consider carrying out this crucial yet time-consuming task. 

Your business plan should include:

  • What you want your practice to specialize in. For example, primary care, family practice, or aging adults. 
  • Where your practice is going to be. The location will be key to the success of your practice, so choose wisely and think about where your patients would be most likely to go and how easily accessible it is to your potential patients. 
  • What your staffing needs are. Although you may want to start small to keep costs down, as your business grows, your staff needs will increase also. Think about whether you need a receptionist or a medical assistant. Make sure you think about the cost of wages, health insurance coverage, labor laws, and any training that will be required. 
  • How you are going to finance your business. Are you planning to take out a small business loan or a standard bank loan? Or are you going to invest your own money? It is always advisable to keep costs to a minimum when starting a new business.

Create a marketing strategy

There is no point in opening your own nurse practitioner practice if nobody knows about it, and that is why having a strong marketing strategy in place is so vital for the survival of your new business, especially in the first “make or break” six months of practice. 

If you are new to the world of marketing, your best bet is to focus on free methods of advertising your new business. One of the most effective digital marketing methods, and one that is virtually free, is social media marketing. Even if your patients themselves are not on social media, it is highly likely their caregivers are, so using these massive online social sharing platforms is crucial to the success of your marketing strategy. 

If you haven’t already, take the time to set up a business page on all the relevant social media channels, including Facebook, Twitter, and Instagram. Once you start to collate followers, you can then focus your efforts on the channels that your patients predominantly use. 

Make sure that you add as much information about your business as possible, including contact details, directions, and opening hours. It can also be a good idea to allow patient reviews, as this can be a great way to attract new patients to your practice. 

Once you become more established as a new business and you have a bit more money to plow into your advertising budget, you may want to consider incorporating some paid advertising into your social media marketing strategy as well as this allows you to reach just your target audience. 

Enlist the help of a mentor

Whether you have undertaken a DNP degree or not before embarking upon starting your own nurse practitioner practice, you will still be faced with issues that you are unprepared to deal with. 

Unfortunately, this is unavoidable and is one of the elements of starting your own business that all new business owners face. Whether you forget to budget in a key element of getting your business started, or you do not have enough staff do cope with initial demand, there will undoubtedly be something that goes wrong in the first few weeks of opening your practice. 

That being said, if you want to avoid the common pitfalls of opening a new nurse practitioner practice, you may want to consider enlisting the help of a mentor. 

If you are keen on the idea of having a business mentor, but you are not sure where to find one, check out the below top tips for finding a business mentor for your new nursing business:

  • Explore your own network. Check your phone, Facebook, and LinkedIn for suitable mentors. 
  • Ask your friends, family, and colleagues. You never know who might know someone with the relevant experience who can help you. 
  • Research the web for influencers. Don’t forget to look at bloggers, journalists, other nurse practitioners, and small business owners. 

Finding the right mentor may take time, but it will be worth it in the effort!

Be optimistic 

If you are already aware of all the scary statistics about how 50% of new businesses fail within the first year, then setting up your own nurse practitioner practice may seem even more daunting. 

However, why not look at it in a different way. If 50% of new businesses fail within the first half a year of opening, that means that 50% don’t. 

Why can’t you be one of the 50% that succeed? 

Furthermore, in terms of the nursing industry in particular, due to a combination of an aging population and a shortage of qualified physicians, there has never been more of a demand for nurse practitioners and, in particular, ones that are DNP degree graduates with exceptional levels of knowledge and expertise. 


That’s it. You are now ready to start your own nurse practitioner practice. 

Still a little worried about taking this next big step in your nursing career?

Take a deep breath and ask yourself the below questions: 

  • Are you ready to be your own boss? 
  • Do you want to be in control of the level of patient care you provide?
  • Are you passionate about a specific aspect of nursing?
  • Do you have the drive and motivation to succeed? 

If you have answered yes to the above, then you are more than ready to start taking the first steps to run your own independent practice. Whether you need to start at the very beginning and arm yourself with the necessary knowledge by undertaking a DNP degree or you are already qualified and can jump in at the deep end, now is the time for you to start preparing for the next chapter of your career, and your life.