Nurse Practitioners in Primary Care

Millions of Americans choose a nurse practitioner (NP) as their primary care provider. NPs are advanced practice registered nurses (APRNs) who are prepared at the master’s or doctoral level to provide primary, acute, chronic and specialty care to patients of all ages and backgrounds. As clinicians who blend clinical expertise in diagnosing and treating health conditions with an emphasis on disease prevention and health management, NPs bring a comprehensive perspective and personal touch to health care. Utilizing NPs to the fullest extent of their education and clinical training — especially in primary care — is critical to meeting the nation’s health care needs and combating chronic disease and rising health care costs.

Primary Care and NP Scope of Practice

NPs diagnose, treat and manage acute and chronic diseases, while emphasizing health promotion and disease prevention. NPs practice in every primary care setting, including but not limited to clinics, health care systems, health maintenance organizations, private physician offices, NP-owned practices, nursing homes, schools, colleges, public health departments, nurse-managed clinics and homeless shelters.

NP practice includes, but is not limited to, assessing patients; ordering, performing, supervising and interpreting diagnostic and laboratory tests; making diagnoses; initiating and managing treatment, including prescribing medication and non-pharmacologic treatments; coordinating care; counseling; and educating patients, their families and their communities. NPs practice autonomously and, like other clinicians, coordinate with health care professionals to manage patients’ health needs. In all 50 states and the District of Columbia, NPs hold prescriptive authority, and they complete nearly 1 billion patient visits annually.

NP Preparation and Growth of the NP Role

About 87% of the 461,000 licensed NPs in the U.S. are educated and prepared in programs that focus on primary care, according to the American Association of Nurse Practitioners® (AANP) 2025 NP count and the 2024 AANP Workforce Survey.

NPs graduate from nationally accredited advanced degree programs that include didactic courses and clinical rotations. These programs are held accountable by the Commission on Collegiate Nursing Education (CCNE) and the Accreditation Commission for Education in Nursing (ACEN) to ensure core content and national education standards are maintained. Both CCNE and ACEN are recognized and accountable to the U.S. Department of Education for maintaining accreditation standards.

NPs are board-certified and pass a standardized national certification exam. These exams are rigorous, psychometrically sound, legally defensible and competency based. They test for knowledge and expertise in patient care. NP certification exams are accredited by the Accreditation Board of Specialty Nursing Certification (ABSNC) and the National Commission of Certifying Agencies (NCCA).

NPs trained in primary care hold certifications in family, adult-geriatrics, pediatrics, and women’s health. These population foci are consistent with the APRN Consensus Model. The scope of practice is not setting-specific but rather is based on the needs of the patient (APRN Consensus Model, 2008). NPs with psychiatric mental health certifications may practice in primary care settings, but this certification is typically not categorized as primary care. Table 1 highlights the percentage of new NP graduates by examination for each primary care certification population.

Table 1 — Distribution of New NP Graduations* by Certification Exam, 2023-2024

* Includes master’s, post-master’s, post-master’s DNP NP and BSN-DNP NP program graduate data.

NPs are one of the most rapidly growing provider groups within the primary care workforce. Recent estimates from the Bureau of Labor Statistics indicate that jobs for NPs are expected to grow by 40% between 2024 and 2034, much faster than the average for all occupations (BLS, 2025). Additionally, an increasing number of Medicare beneficiaries are seeing NPs for their primary care needs (Medicare Payment Advisory Commission, 2022). Within rural and underserved communities, NPs provide a larger share of primary care to patients. A recent study found that 53.4% of U.S. primary care practices employed NPs in 2023, and primary care practices with NPs are significantly more likely to be located in rural and low-income areas than practices without NPs (O’Reilly-Jacob et al. 2025).

The overall number of NP graduates is growing, although the mix of certifications they receive is changing to meet evolving health care needs within the U.S. Data from the American Association of Colleges of Nursing show that the number of NP graduates in primary care has been stable in recent years (see Table 2). In contrast, psychiatric mental health and acute care graduations have grown, although their numbers are still smaller than primary care.

Table 2 — Growth in Primary Care NP Graduations* and Percentage Increase by Year, 2019-20 to 2023-2024

* Includes master’s, post-master’s, post-master’s DNP NP and BSN-DNP program graduate data.

Summary

For more than 50 years, NPs have provided patient-centered health care to a broad range of populations — with positive patient outcomes and cost savings observed. A brief review of studies examining NP outcomes is available in the Quality of Care Bibliography and NP Cost-Effectiveness position papers. Currently, our nation is facing new and emerging health care challenges. As noted by the National Academies of Sciences, Engineering, and Medicine (2021), there is a critical need for all primary care providers to function at the fullest extent of their scope of practice. By establishing a strong health care system with a robust primary care workforce, the U.S. can better address its aging population, rising health care costs and the growing burden of chronic disease. NPs are key to building this solid foundation and bring added strength to the health care workforce. Maximizing this available potential is pivotal to addressing the current and emerging challenges.

References

American Association of Colleges of Nursing (2015-2021). Enrollment and Graduations in Baccalaureate and Graduate Programs in Nursing. Washington, D.C.

American Association of Nurse Practitioners. (2024). AANP 2024 Nurse Practitioner Workforce Survey. https://www.aanp.org/practice/practice-related-research/research-reports

Medicare Payment Advisory Commission. 2022. Report to the Congress: Medicare Payment Policy. Washington, DC: MedPAC.

National Academies of Sciences, Engineering, and Medicine. (2021). The future of nursing 2020-2030: Charting a path to achieve health equity. Washington, DC: The National Academies Press.

National Council of State Boards of Nursing. (2008). APRN Consensus Model: The consensus model for APRN regulation, licensure, accreditation, certification and education. https://www.ncsbn.org/nursing-regulation/practice/aprn.page

O’Reilly-Jacob, M., Featherson, K. G., Barnes, H., Xue, Y., and Poghosyan, L. (2025). Socioeconomic characteristics of communities with primary care practices with nurse practitioner. Jama Network Open. 8(2). doi: 10.1001/jamanetworkopen.2024.62360

U.S. Bureau of Labor Statistics. (2025, August). Fastest Growing Occupations. Accessed October 2, 2025. https://www.bls.gov/ooh/fastest-growing.htm.

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^©American Association of Nurse Practitioners. Revised October 2025.