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Nursing Requirements by State: A Credentialing Guide for Facilities

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Written by Kathleen Walder Content Writer, IntelyCare

Reviewed by Diana Campion, MSN, APRN, ANP-C Content Writer, IntelyCare

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Making sure your facility’s nurses have the necessary credentials is crucial for the safety of your patients, the reputation of your facility, and adherence to state and federal laws. This is particularly important during the hiring process. When it comes to nursing requirements, the standards for credentialing vary by state, title, and function.

This guide will explain the U.S. credentialing system and national mandates for nursing professionals. Click on the links to the corresponding states in the table below to learn more about nurse requirements for basic roles like CNA, LPN, RN, and APRN, plus any specialization credentials of note.

What Is Credentialing?

The term “credentialing” refers to the process of determining whether an individual (in this case, a nurse candidate) has met certain standards set by a state or federal governmental agency, or professional organization, that is tasked with making this determination. Nursing credentials include three components: accreditation, certification, and licensure.

1. Accreditation

Educational institutions control the accreditation portion of credentialing. To obtain credentials, a nurse must take classes or graduate from an accredited educational institution such as a school, college, or university. Federal and state governmental agencies (and non-governmental organizations) evaluate an institution’s programs to verify whether they meet predetermined criteria or standards.

2. Certification

Non-governmental agencies and associations grant certifications to nurses. Certification in a particular practice area determines a nurse’s role, title, and status. Certifications apply nationally, and nurses can hold more than one certification.

The agency or association sets the nursing requirements for certifications, which typically involve education from an accredited institution and a passing grade on an exam. Certifications may require additional continuing education and renewal to stay current.

3. Licensure

Government agencies are responsible for credentialing and issue licenses allowing nurses to practice in that state. The purpose of licensing is to ensure that the public’s health, safety, and welfare will be reasonably well-protected.

The nursing requirements to obtain a license include education from an accredited institution and verification that they’ve attained the minimal degree of experience and competency in their profession. These depend on the role and state requirements, ranging from no degree to an advanced degree. For example, a CNA, LPN, or RN would not need an MSN to practice in any state. Licensing often involves testing and a fee, and may require continuing education classes and license renewal on a regular basis.

The most common nurse credentialing examples are:

Certified Nursing Assistant (CNA)
Licensed Practical Nurse (LPN)
Registered Nurse (RN)
Advanced Practice Registered Nurse (APRN)
Certified Registered Nurse Anesthetist (CRNA)
Clinical Nurse Specialist (CNS)
Nurse Practitioner (NP)

A Healthcare Provider’s Role in Credentialing

As an organization that employs nurses and provides healthcare services, you’re responsible for verifying the certification and licensure of your nurse employees in states where you do business. Ensuring that your nurses are properly credentialed, especially if you operate in multiple states, can be complicated. Here are answers to some frequently asked questions about nurse credentialing.

Are Credentialing Requirements Different in Each State?

Each state sets its own licensing requirements regarding education, experience, certification, and testing. Some states require both a government-issued license and an association certification to allow a nurse to practice in that state. Nursing requirements by state can be confusing since state agencies and professional organizations may use different names for the same occupation. For example, while New Jersey uses the term “Certified Nursing Assistant,” Maryland describes the same position as a “Geriatric Nursing Assistant.”

Who Has the Ultimate Authority to Allow Nurses to Practice in a State?

The state has the ultimate authority to allow nurses to practice within its borders. State nursing boards define the scope of practice for each role and also may take actions to censure or revoke certifications. State government license requirements:

include basic education, competency, and continuing education
set practice parameters
investigate complaints against licensees
take disciplinary action when necessary

Can Nurses From Other Countries Be Licensed in the U.S.?

Yes, internationally educated nurses can be licensed to practice in the U.S. Like all nurses, they must take the NCLEX. The NCLEX requirements by state for foreign nurses pertain to their scores on an English Language Proficiency Exam. Many states do not require scores to grant licensure.

Can You Hold a Nursing License in Multiple States?

Knowing whether a nurse is allowed to practice in more than one state is important to the nurse and the employer. The healthcare industry has developed a remedy for this situation by creating the Nurse Licensure Compact (NLC) that allows LPNs, LVNs, and RNs licensed in one NLC state to practice in another NLC state. To participate, a nurse must register a state of residence. This facilitates travel nurses and those using telehealth in their practices.

How Do I Verify a Nurse’s Licensure and Authority to Practice?

The Nursys national database, maintained by the National Council of State Boards of Nursing, Inc. (NCSBN), tracks the licensure and disciplinary records of nurses. You can search for nurses by name, license number, or NCSBN ID.