First Steps After Deciding to Open Your Practice

So you’ve made the decision: you’re going to open your own nurse practitioner practice.

You’re excited. You’re nervous. You’re picturing the name on the door, your first patients, and the freedom of running things your way. But then the big question hits: Where do I start?

Here’s the truth — the most important work happens before you file your LLC paperwork, lease a space, or design a logo. Skipping these early steps is one of the biggest mistakes new practice owners make, and it’s often the reason they feel overwhelmed or financially strained later on.

I’ve broken this into the three key steps you should take first, so you can build your foundation before jumping into the fun (and sometimes expensive) parts.

Step 1: Get Clear on Your Vision

Opening a practice is more than a job change — it’s building a lifestyle, a brand, and a long-term commitment. Before you even look at office space, get crystal clear on:

• Your “why” — What’s the real reason you want your own practice? Freedom? Impact? A better patient experience? More income? Your “why” will keep you grounded when challenges come.

• Your ideal patient — Who do you want to serve? This influences location, services, pricing, and marketing.

• Your scope and niche — Will you be primary care, functional medicine, aesthetics, a specialty clinic? Are you open to hybrid models like telehealth plus in-person?

• Your desired schedule — Are you envisioning four long days, shorter hours, seasonal breaks? Decide now so you build a model that supports it.

Write this vision down. You’ll refer to it constantly when decisions come up — and they will come up fast.

Step 2: Map Out the Money

This is the step too many NPs skip because it feels intimidating — but it’s what protects you from sinking under stress.

• Know your startup costs — Licensing, legal fees, insurance, equipment, EMR system, furniture, initial supplies, marketing, and possibly lease deposits.

• Estimate your monthly expenses — Rent/mortgage, payroll (if any), utilities, software subscriptions, insurance, loan payments, and supplies.

• Project your revenue — Based on realistic patient volume and pricing. If you’re insurance-based, research reimbursement rates; if you’re cash pay, set pricing that balances value and sustainability.

• Decide your risk tolerance — How much of your own savings will you use? Will you need a small business loan? Will you start part-time while keeping another income stream?

Your goal here isn’t perfection — it’s clarity. Even a simple spreadsheet showing “startup costs + monthly expenses + projected income” will help you see if your plan is viable.

Step 3: Build Your Support System Before You Launch

You might be the only clinician in your practice, but you do not want to do this alone.

• Mentorship — Find a mentor who has successfully opened a practice. They’ve already navigated licensing, credentialing, EMR choices, and patient flow. Their advice can save you from costly mistakes.

• Professional network — Connect with other healthcare providers, local business owners, and referral partners. These relationships will help you grow faster than any ad campaign.

• Legal & financial help — Hire (or at least consult with) a healthcare attorney and an accountant who understand NP practices. You don’t have to keep them on retainer, but you want them in your corner for setup and compliance.

• Personal support — Running a practice affects your family, your schedule, and your energy. Having your partner, family, or friends on board will make the journey far smoother.

Bonus Tip: Don’t Rush the Timeline

I know the temptation — you want to open now. But giving yourself 3–6 months (or longer) to prepare will pay off. That’s time to research, save, network, and make intentional decisions. A rushed start often means expensive do-overs.

Your First Steps Are the Most Powerful

Once you have your vision, your financial picture, and your support system in place, everything else — licensing, location, branding, hiring, marketing — will flow much more smoothly. You’ll feel less overwhelmed, make better decisions, and be far more likely to build a practice you love running long-term.

Remember: opening your own practice isn’t just a business move. It’s a chance to design the career and life you’ve always wanted. Start strong, and you’ll thank yourself every step of the way.

If you’re ready to take these first steps but want guidance from someone who’s been there, I’d love to help. I offer coaching and mentorship for nurse practitioners ready to launch their own practice with clarity, confidence, and support. You don’t have to figure it all out alone — let’s build your dream practice together.