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History Note:        Authority G.S. 90-6; 90-18(14); 90-18.2; 90-171.20(4); 90-171.20(7); 90-171.23(b); 90-171.83;

Recodified from 21 NCAC 36 .0227(a) Eff. August 1, 2004.

Amended Eff. December 1, 2006; August 1, 2004.

21 NCAC 36 .0802             SCOPE OF PRACTICE

A nurse practitioner shall be held accountable by both Boards for the continuous and comprehensive management of a broad range of personal health services for which the nurse practitioner is educationally prepared and for which competency has been maintained, with physician supervision and collaboration as described in Rule .0810 of this Section.  These services include but are not restricted to:

(1)           promotion and maintenance of health;

(2)           prevention of illness and disability;

(3)           diagnosing, treating and managing acute and chronic illnesses;

(4)           guidance and counseling for both individuals and families;

(5)           prescribing, administering and dispensing therapeutic measures, tests, procedures and drugs;

(6)           planning for situations beyond the nurse practitioner's expertise, and consulting with and referring to other health care providers as appropriate; and

(7)           evaluating health outcomes.

History Note:        Authority G.S. 90-18(14); 90-171.20(7); 90-171.23(b)(14);

Recodified from 21 NCAC 36 .0227(b) Eff. August 1, 2004;

Amended Eff. August 1, 2004.


(a)  The Board of Nursing shall register an applicant who:

(1)           has an unrestricted license to practice as a registered nurse in North Carolina and, when applicable, an unrestricted approval, registration or license as a nurse practitioner in another state, territory, or possession of the United States;

(2)           has successfully completed a nurse practitioner education program as outlined in Rule .0805 of this Section;

(3)           is certified as a nurse practitioner by a national credentialing body consistent with 21 NCAC 36 .0120(7) and (9); and

(4)           has supplied additional information necessary to evaluate the application as requested.

(b)  Beginning January 1, 2005, new graduates of a nurse practitioner program, who are seeking first-time nurse practitioner registration in North Carolina shall:

(1)           hold a Master's or higher degree in Nursing or related field with primary focus on Nursing;

(2)           have successfully completed a graduate level nurse practitioner education program accredited by a national accrediting body; and

(3)           provide documentation of certification by a national credentialing body.

History Note:        Authority G.S. 90-18(c)(13); 90-18.2; 90-171.20(7); 90-171.23(b); 90-171.83;

Eff. August 1, 2004;

Amended Eff. November 1, 2008; December 1, 2006.


(a)  Prior to the performance of any medical acts, a nurse practitioner shall:

(1)           meet registration requirements as specified in 21 NCAC 36 .0803 of this Section;

(2)           submit an application for approval to practice;

(3)           submit any additional information necessary to evaluate the application as requested; and 

(4)           have a collaborative practice agreement with a primary supervising physician.

(b)  A nurse practitioner seeking approval to practice who has not practiced as a nurse practitioner in more than five years shall complete a nurse practitioner refresher course approved by the Board of Nursing in accordance with Paragraphs (o) and (p) of 21 NCAC 36 .0220 and consisting of common conditions and their management directly related to the nurse practitioner's area of education and certification.

(c)  The nurse practitioner shall not practice until notification of approval to practice is received from the Boards.

(d)  The nurse practitioner's approval to practice is terminated when the nurse practitioner discontinues working within the approved nurse practitioner collaborative practice agreement, or experiences an interruption in her/his registered nurse licensure status, and the nurse practitioner shall notify both Boards in writing.  The Boards may extend the nurse practitioner's approval to practice in cases of emergency such as injury, sudden illness or death of the primary supervising physician.

(e)  Applications for approval to practice in North Carolina shall be submitted to the Board of Nursing and then approved by both Boards as follows:

(1)           the Board of Nursing shall verify compliance with Rule .0803 and Paragraph (a) of this Rule; and

(2)           the Medical Board shall verify that the designated primary supervising physician holds a valid license to practice medicine in North Carolina and compliance with Paragraph (a) of this Rule.

(f)  Applications for approval of changes in practice arrangements for a nurse practitioner currently approved to practice in North Carolina:

(1)           addition or change of primary supervising physician shall be submitted to both Boards; and

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