Private Practice for Nurse Practitioners: Where You Can Work Independently

One of the most common questions I get from other nurse practitioners is:

“Can I start my own private practice in my state?”

The answer depends on where you live. State laws around nurse practitioner (NP) practice authority vary—some states give NPs full independence, while others require a formal agreement with a physician.

I’ve experienced this firsthand. When I practiced in Indiana, I needed a collaborative agreement with a physician in order to prescribe and operate a private practice. It worked, but it came with extra hoops—more paperwork, more limitations, and less freedom to fully design my practice.

When I moved to Oregon, everything changed. Oregon is a full practice authority state, which means I’m licensed to evaluate, diagnose, treat, and prescribe without physician oversight. Now I run my own integrative health practice independently, and that shift has been completely transformational for how I work and care for others.

🩺 Understanding Practice Authority for NPs

Here’s a quick breakdown of how states categorize NP practice authority:

• Full Practice
  I can practice independently—no physician required. I have full authority to assess, diagnose, treat, and prescribe.
  (Oregon, Washington, Idaho, Montana, Arizona, Colorado, and many others)

• Reduced Practice
  I’m able to provide care within my scope of practice, but I need a collaborative agreement with a physician for at least one element—often prescribing.
  (Indiana is in this group.)

• Restricted Practice
  I must practice under direct supervision or delegation from a physician for core clinical functions. These states have the most limitations.

🌍 Why Where You Practice Matters

If you’re dreaming about starting your own practice, it’s essential to understand your state’s regulations. Even the most skilled and experienced NP can be held back by laws that limit our scope. In full practice states, we can fully step into the role of independent providers—designing care that’s creative, patient-centered, and aligned with our values.

That said, you can absolutely build a thriving private practice in a reduced practice state. It requires a bit more intention on the front end, but if you can form a strong, respectful relationship with a collaborative physician, it can work beautifully. Many successful NPs run practices in these states—they just take the extra step to create clear agreements and mutual trust with their collaborators.

Moving from Indiana to Oregon didn’t just mean a change of scenery—it gave me the freedom to build a practice that truly reflects who I am. I’ve never felt more aligned, both personally and professionally.

💡 Thinking About Going Independent?

If you’re an NP who’s wondering what’s possible for your own future, I encourage you to check your state’s laws—and don’t be afraid to dream bigger. Whether you’re in a full, reduced, or restricted practice state, there are always ways forward.

And if you’re looking for support, I’d love to share what I’ve learned.
Helping other NPs step into their own private practice is one of my greatest joys. Reach out anytime.