Typical entry route
Master's degree
~5 years to median pay
Outlook
Growing demand
Nurse practitioners are the registered nurses who went back to school to diagnose and treat patients themselves. In the US that extra step is worth about $35,000 a year at the median, and BLS expects it to be one of the fastest-growing jobs of the next decade. The title, the training and the pay look very different in Canada and the UK, which is why this page covers those three countries with official figures and leaves out countries where no official pay data exists.
What the job actually is
A nurse practitioner (NP) works much like a primary care doctor or hospital specialist on a defined scope: taking a history, examining the patient, ordering tests, making a diagnosis and prescribing treatment. Many work in primary care clinics and hospitals; others specialise in areas such as acute care, mental health, paediatrics or women’s health.
How independently they work depends on the law. In the US, 27 states and DC give nurse practitioners full practice authority under the state board of nursing, 12 states restrict part of the role, and 11 require supervision, delegation or team management by another provider for the whole career (American Association of Nurse Practitioners, May 2026). In the UK, “advanced nurse practitioner” isn’t a protected title: the Nursing and Midwifery Council has published advisory principles and plans to start work on standards for advanced practice in early 2027.
What it really pays
| Country | Median (official) | Source |
|---|---|---|
| United States | $132,300 | BLS, May 2025 |
| Canada | C$128,003 (C$61.54 an hour) | Job Bank, Nov 2025 |
| United Kingdom | £47,673 | ONS ASHE, 2026 provisional |
| California (state median) | $168,520 | BLS, May 2025 |
In the UK, NHS pay follows Agenda for Change bands, set for each post by local job evaluation. Advanced practice posts are usually at Band 7 (£49,387 to £56,515 in England from 1 April 2026) or Band 8a (£57,528 to £64,750), with London weighting on top (NHS Employers, pay scales 2026/27). Elsewhere, public scales set the pay: Ireland’s HSE pays advanced nurse practitioners €72,843 to €89,894 from 1 June 2026, and NSW public hospitals pay nurse practitioners A$3,032.60 to A$3,247.10 a week from 1 July 2026 (NSW Health IB2026_018), and Queensland Health’s EB12 offer table puts them on A$6,040.00 to A$6,306.00 a fortnight from 1 April 2026. We don’t publish salary pages for those countries yet, because we don’t have an official statistic for the job there to build them on.
The realistic path in
United States
- Become a registered nurse and pass the NCLEX-RN. Our registered nurse salary page covers that stage.
- Gain nursing experience. Programs set their own requirements, and many applicants work as RNs for several years first.
- Earn a master’s (MSN) or doctoral (DNP) degree in an advanced practice role, such as family, adult-gerontology or psychiatric-mental health nurse practitioner.
- Pass a national certification exam and get your state APRN license (BLS).
Canada: you need RN registration, an approved nurse practitioner master’s or post-master’s program, and the new national exam: the Canadian Nurse Practitioner Licensure Exam (CNPLE) has been Ontario’s approved exam since 1 July 2026 and becomes British Columbia’s only accepted exam on 1 January 2027, plus a provincial jurisprudence exam (College of Nurses of Ontario; BCCNM).
United Kingdom: NMC registration as a nurse, years of experience, then a master’s-level advanced clinical practice programme covering clinical practice, leadership, education and research (Health Education England framework, 2017).
The honest downsides
The route is long and mostly self-funded: a nursing degree, years at the bedside and a graduate program, often studied part time while working. Scope-of-practice rules are politically contested in the US, so what you may do can depend on the state and on your employer’s policies. In the UK the unprotected title means two “advanced nurse practitioner” jobs can carry very different responsibility and pay, so check the band and the job description.
What you get in return is a clinical role with real autonomy and, in the US, a median above $130,000 with demand in every state.
Why it's worth it
- A big step up from nursing pay: the US median is $132,300, about $35,000 more than registered nurses earn (BLS, May 2025)
- One of the fastest-growing jobs in the US: BLS projects 41% growth from 2025 to 2035, about 137,800 more jobs
- Real clinical autonomy: in 27 states and DC, nurse practitioners can diagnose, treat and prescribe without a doctor's supervision
The trade-offs
- A long route: a nursing degree and licence, usually years of nursing experience, then a master's or doctoral program
- Scope depends on where you work: 11 US states still require career-long supervision or team management by another provider
- In the UK the title isn't protected, so job titles and pay vary between employers
Frequently asked questions
How much does a nurse practitioner make?
In the US the BLS median is $132,300 a year, about $63.61 an hour. The lowest-paid 10% earn under $101,340 and the top 10% more than $174,420 (OEWS, May 2025). In Canada the Job Bank median is C$61.54 an hour (about C$128,000 a year), and in the UK the ONS median for full-time nurse practitioners is £47,673 (2026).
Which state pays nurse practitioners the most?
California, with a median of $168,520 a year, then New Jersey at $159,310, Washington at $156,100 and Oregon at $155,680 (BLS, May 2025). Our US salary page has every state and city, with each state's pay adjusted for local prices.
How much more do nurse practitioners earn than registered nurses?
In the US, the median nurse practitioner earns $132,300 a year against $97,550 for registered nurses (BLS, May 2025): about $34,750 more, or 36%. The gap reflects the extra education (a master's or doctorate) and the prescribing and diagnostic responsibility.
Do you need a doctorate to be a nurse practitioner?
No. In the US you need at least a master's degree in an advanced practice nursing role, then a national certification exam and a state license (BLS). Some nurses take a Doctor of Nursing Practice (DNP), but a master's is the minimum. In Canada, nurse practitioners usually need a master's degree in nursing (Job Bank).
Figures are gross yearly pay. Where an official statistics office publishes pay for the job (BLS in the US, ONS in the UK, Job Bank in Canada, the Ministry of Manpower in Singapore, Jobs and Skills Australia, the Bundesagentur für Arbeit in Germany, CBS in the Netherlands, the Federal Statistical Office in Switzerland, INE in Spain) we show its figures; everywhere else they are Paygrade estimates from our salary model, explained on the methodology page. Actual pay varies by location, employer and experience. Last updated 28 October 2026.