Best States to Work as a Nurse Practitioner (NP)

More than 461,000 nurse practitioners are licensed in the United States as of late 2025, and the count keeps climbing fast. NP is among the fastest-growing occupations in the country. One of the job's biggest advantages is flexibility, and where you practice shapes your pay, your autonomy, and your day-to-day.

We used a data-driven methodology to rank the best states for NPs, with input from Elizabeth Clarke, FNP, MSN, RN, MSSW, and Joelle Y. Jean, FNP-C, BSN, RN, who weighted the factors that matter most when choosing a state. The ranking scores nine variables: independent practice, pre-pandemic job satisfaction (2018), projected job growth, projected NP openings per year, NPs currently employed, average hourly salary, purchasing power, and outpatient and hospital NP salary adjusted for cost of living.

The per-state figures below reflect the BLS (2022), Projections Central (2020-2030), and HRSA (2018) releases cited in the methodology, so read them as the ranking's vintage rather than current-day numbers.

The top 10 states for nurse practitioners

1. Arizona

Arizona takes the top spot. NPs have full practice authority and prescriptive privileges, so they can work independently without a collaborating physician. The climate is a draw too, with hot summers and mild winters.

• Weighted score: 0.940
• Average hourly salary: $58.37
• Projected NP openings per year (2020-2030): 910
• Strengths: projected job growth, projected openings, independent practice
• Weaknesses: outpatient salary for cost of living, average hourly salary, purchasing power

2. New Mexico

New Mexico NPs earn above the national average at $62.29 an hour, with full practice authority and prescription privileges. The downside is volume: only about 140 projected openings a year.

• Weighted score: 0.896
• Average hourly salary: $62.29
• Projected NP openings per year (2020-2030): 140
• Strengths: independent practice, outpatient salary for cost of living, hospital salary for cost of living
• Weaknesses: projected openings, NPs currently employed, average hourly salary

3. Iowa

Iowa offers independent practice, prescriptive authority, and a comfortable cost of living for hospital-based NPs. Openings are projected under 3,000 over the decade, and the state runs through four distinct seasons.

• Weighted score: 0.893
• Average hourly salary: $61.62
• Projected NP openings per year (2020-2030): 260
• Strengths: independent practice, hospital salary for cost of living, projected job growth
• Weaknesses: projected openings, NPs currently employed, pre-pandemic job satisfaction

4. New York

New York consistently ranks high, with strong salaries and plenty of openings across a mix of city and suburban life. NPs can practice independently and open clinics, though job satisfaction is a weak point: only 40% of New York NPs reported satisfaction in 2018, against 47% nationally. Cost of living runs high depending on where you settle.

• Weighted score: 0.884
• Average hourly salary: $64.39
• Projected NP openings per year (2020-2030): 2,060
• Strengths: projected openings, NPs currently employed, independent practice
• Weaknesses: pre-pandemic job satisfaction, purchasing power, outpatient salary for cost of living

5. Oregon

Oregon offers full practice authority, prescription privileges, and the fourth-highest hourly salary at $65.51, plus strong projected job growth. The tradeoff is cost of living, which climbs in parts of the state.

• Weighted score: 0.883
• Average hourly salary: $65.51
• Projected NP openings per year (2020-2030): 300
• Strengths: independent practice, projected job growth, average hourly salary
• Weaknesses: NPs currently employed, projected openings, purchasing power

6. Minnesota

Minnesota pairs independent practice with a solid hourly wage and a comfortable cost-of-living-adjusted salary for hospital NPs. Expect snowy winters and warm summers, and roughly 450 projected openings a year.

• Weighted score: 0.883
• Average hourly salary: $61.62
• Projected NP openings per year (2020-2030): 450
• Strengths: independent practice, average hourly salary, hospital salary for cost of living
• Weaknesses: outpatient salary for cost of living, projected openings, projected job growth

7. Washington

Washington offers strong salaries, independent practice, and prescription privileges, with about 690 projected openings a year and a mix of outdoor and urban living.

• Weighted score: 0.878
• Average hourly salary: $65.19
• Projected NP openings per year (2020-2030): 690
• Strengths: independent practice, projected openings, average hourly salary
• Weaknesses: NPs currently employed, outpatient salary for cost of living, purchasing power

8. Montana

Montana NPs reported a 50% job satisfaction rate in 2018, can practice independently with prescription privileges, and benefit from promising growth and a near-average cost of living. The outdoor lifestyle in Big Sky Country is part of the appeal.

• Weighted score: 0.856
• Average hourly salary: $57.67
• Projected NP openings per year (2020-2030): 80
• Strengths: independent practice, pre-pandemic job satisfaction, projected job growth
• Weaknesses: NPs currently employed, projected openings, outpatient salary for cost of living

9. New Hampshire

New Hampshire offers above-average salaries, independent practice, and prescription privileges, with strong outdoor recreation. Job satisfaction ranked low, at 38% in 2018.

• Weighted score: 0.834
• Average hourly salary: $60.47
• Projected NP openings per year (2020-2030): 140
• Strengths: average hourly salary, independent practice, hospital salary for cost of living
• Weaknesses: projected openings, projected job growth, NPs currently employed

10. North Dakota

North Dakota projects about 90 openings a year, second-lowest in the top 10, but hospital NPs can clear $130,000 a year once salary is adjusted for cost of living. NPs get independent practice and prescription privileges, in a state with a wide temperature swing.

• Weighted score: 0.832
• Average hourly salary: $54.78
• Projected NP openings per year (2020-2030): 90
• Strengths: purchasing power, independent practice, hospital salary for cost of living
• Weaknesses: projected openings, projected job growth, NPs currently employed

States with the largest scope of practice

Full practice authority lets NPs work at the top of their license without physician supervision, which expands professional autonomy and improves access to care, especially in rural and underserved areas. As of 2025, 27 states and Washington, D.C., grant full practice authority:

Alaska, Arizona, Colorado, Connecticut, Delaware, Hawaii, Idaho, Iowa, Kansas, Maine, Maryland, Massachusetts, Minnesota, Montana, Nebraska, Nevada, New Hampshire, New Mexico, New York, North Dakota, Oregon, Rhode Island, South Dakota, Utah, Vermont, Washington, Wyoming, and Washington, D.C.

The American Association of Nurse Practitioners describes full practice authority as letting NPs "evaluate patients; diagnose, order and interpret diagnostic tests; and initiate and manage treatments, including prescribing medications and controlled substances, under the exclusive licensure authority of the state board of nursing."

Even full-authority states attach conditions. New York, for example, requires a written practice agreement with a collaborating physician until an NP completes 3,600 hours of clinical experience. NPs in reduced or restricted states can prescribe only with physician signoff, and moving a state from restricted to full authority takes legislation.

Where the opportunities are

The states with the most openings draw NPs starting out or looking for a change, offering job security, development, and better pay. But high projected growth doesn't always mean the most openings, so look at both before you decide. High demand can also signal something worth checking. As Clarke puts it, "High turnover typically means low job satisfaction. The less turnover or fewer openings means higher job satisfaction."

NP salaries by state

The BLS puts the median NP salary at $129,210 a year as of May 2024. The top-paying states push well above that, and setting matters: hospital NPs generally earn more than those in outpatient centers. In New Mexico, for instance, hospital NPs average about $151,313 a year adjusted for cost of living, against $144,104 for outpatient NPs.

Purchasing power is worth weighing too. NP salaries in Iowa and New Mexico stretch about 10% further than the national average. When you negotiate, factor in housing, food, and transportation, and don't overlook the hospital-versus-outpatient gap.

Methodology and sources

The ranking uses a weighted average across nine metrics: scope of practice, average hourly salary, purchasing power, outpatient and hospital NP salary adjusted for cost of living, projected job growth, projected openings per year, NPs currently employed, and pre-pandemic job satisfaction. The salary index averages the hourly salary index with the cost-of-living-adjusted outpatient and hospital salary indexes. The opportunity index averages projected annual openings and current employment.

Sources include Projections Central, the Bureau of Labor Statistics, the American Association of Nurse Practitioners, BEA Regional Price Parity, the HRSA Nursing Workforce Dashboard, the American Medical Association's 2017 nurse practitioner prescriptive authority chart, and the DEA's Mid-Level Practitioner Controlled Substance Authorization by State guide (last updated 2022).

Practice authority came from the AANP; prescriptive authority from the AMA chart and the DEA guide. Projected openings and growth came from Projections Central's 2020-2030 data. Purchasing power used 2021 BEA regional price parity. Employment and hourly salary came from 2022 BLS data; New York salary used 2021 because 2022 was unavailable. Purchasing power tells you how far a paycheck stretches against the national average, and each state's outpatient and hospital salaries were multiplied by that figure to adjust for cost of living.

Job satisfaction came from the HRSA dashboard, measured as the share of NPs who reported being extremely satisfied, using 2018 data. HRSA has not released post-pandemic figures. In several states, as many as 24% of NPs didn't report satisfaction, and small samples in states like Wyoming, Montana, and the Dakotas were reported in pairs, with the same percentage applied to both.