You might be wondering, Can nurse practitioners prescribe medication? The answer is yes, but it depends on the nurse practitioner’s prescriptive authority and the scope of practice defined by state law.
The role of nurse practitioners has expanded significantly over the past few decades, and prescribing has become a central part of their contribution to patient care. According to the American Association of Nurse Practitioners (AANP), there are now more than 385,000 licensed nurse practitioners in the U.S., and the majority provide primary care services.
As advanced practice registered nurses, NPs are trained to diagnose conditions, interpret diagnostic tests, and, in many states, prescribe medications, including certain controlled substances.
Here’s a closer look at how nurse practitioner prescribing works across the United States.
Understanding Nurse Practitioner Authority
In the U.S., nurse practitioner prescribing rights are categorized into three tiers: full practice authority, reduced practice, and restricted practice.
- Full practice authority grants NPs the ability to evaluate patients, interpret diagnostic tests, prescribe independently, manage patient care, and write prescriptions without a collaborating or supervising physician. As of 2025, 34 states plus the District of Columbia offer this level of autonomy.
- Reduced practice allows NPs to manage part of their scope, such as interpreting diagnostic tests or prescribing, but under a collaborative agreement or with physician involvement required.
- Restricted practice requires ongoing physician supervision or delegation for most elements of practice, including prescriptive authority, especially for controlled substances.
What Medications Can Nurse Practitioners Prescribe?
When granted the authority, nurse practitioners can prescribe a wide range of prescription drugs that cover everything from primary care to specialty treatments.
- Standard medications: These include everyday prescriptions like antibiotics, blood pressure medications, and chronic disease therapies. These prescriptions represent a large share of NP practice and are essential to meeting the growing demand for accessible healthcare.
- Controlled substances: Some states permit NPs to prescribe schedule II or schedule III drugs, such as opioids for pain management or stimulants for ADHD, while requiring additional federal registration or a collaborating physician for oversight.
- Psychiatric medications: Where advanced training in advanced pharmacology exists and state law allows, NPs may prescribe for severe psychological conditions.
Nurse Practitioners and Collaborative Agreements
In states without full autonomy, nurse practitioners may prescribe medications, but often under a collaborative agreement or with a supervising physician in place.
This is especially common when it comes to prescribing controlled substances or schedule II drugs, where physician involvement is legally required.
These agreements outline the exact boundaries of an NP’s prescriptive authority. They specify which medications can be prescribed independently, which require physician approval, and how patient care will be monitored. In effect, they create a framework that balances nurse practitioner prescribing with physician oversight.
How Medical Director Co. Helps Nurse Practitioners
At Medical Director Co., we make the path to safe, compliant NP prescribing simple. If you practice in a restricted or reduced practice state, we’ll connect you with a collaborating or supervising physician and help set up the right agreements.
We also assist with the required federal registration and ensure your scope of practice follows state laws and nursing board regulations.
Whether you’re in a full practice authority state or one that requires physician oversight, Medical Director Co. is here to support you. Get matched with a qualified medical director in 24 hours—risk-free, compliant, and now $200 off your first month.
Frequently Asked Questions
Can nurse practitioners prescribe medication without physician supervision?
Yes, but only in full practice authority states. As of 2025, 34 states and Washington, D.C. allow nurse practitioners to prescribe independently, including most prescription drugs, controlled substances, and even schedule II medications in some jurisdictions. In reduced or restricted practice states, a collaborative agreement with a supervising physician is usually required.
Can nurse practitioners prescribe controlled substances?
Nurse practitioners may prescribe controlled medications such as schedule II and schedule III drugs if state law allows and they hold a Drug Enforcement Administration (DEA) registration. Some states restrict what NPs may prescribe, especially with schedule II substances, while others grant full prescriptive authority.
Can nurse practitioners prescribe psychiatric medications?
Yes. With proper training in advanced pharmacology and state board approval, NPs can prescribe psychiatric medications for conditions ranging from anxiety to severe psychological disorders. In some states, physician supervision is required for certain prescriptions.
Do nurse practitioners need a DEA number to prescribe?
If an NP wants to prescribe controlled substances, they must obtain a DEA number in addition to their state license. This ensures compliance with federal government regulations.
Can nurse practitioners prescribe schedule II medications like opioids or stimulants?
Yes, in states where nurse practitioner’s prescriptive authority includes schedule II substances. However, prescribing schedule II drugs often comes with stricter monitoring and may require physician approval in states with reduced or restricted authority.
How does a collaborative agreement affect NP practice?
In states without full prescriptive authority, NPs may only write prescriptions under the terms of a collaborative agreement with a collaborating physician. These agreements define which medications the NP may prescribe, such as legend and controlled medications, and when physician involvement is necessary.
Can nurse practitioners prescribe medication without physician supervision?
Yes, but only in full practice authority states. As of 2025, 34 states and Washington, D.C. allow nurse practitioners to prescribe independently, including most prescription drugs, controlled substances, and even schedule II medications in some jurisdictions. In reduced or restricted practice states, a collaborative agreement with a supervising physician is usually required.
Can nurse practitioners prescribe controlled substances?
Nurse practitioners may prescribe controlled medications such as schedule II and schedule III drugs if state law allows and they hold a Drug Enforcement Administration (DEA) registration. Some states restrict what NPs may prescribe, especially with schedule II substances, while others grant full prescriptive authority.
Can nurse practitioners prescribe psychiatric medications?
Yes. With proper training in advanced pharmacology and state board approval, NPs can prescribe psychiatric medications for conditions ranging from anxiety to severe psychological disorders. In some states, physician supervision is required for certain prescriptions.
Do nurse practitioners need a DEA number to prescribe?
If an NP wants to prescribe controlled substances, they must obtain a DEA number in addition to their state license. This ensures compliance with federal government regulations.
Can nurse practitioners prescribe schedule II medications like opioids or stimulants?
Yes, in states where nurse practitioner’s prescriptive authority includes schedule II substances. However, prescribing schedule II drugs often comes with stricter monitoring and may require physician approval in states with reduced or restricted authority.
How does a collaborative agreement affect NP practice?
In states without full prescriptive authority, NPs may only write prescriptions under the terms of a collaborative agreement with a collaborating physician. These agreements define which medications the NP may prescribe, such as legend and controlled medications, and when physician involvement is necessary.
Blaz Korosec is the CEO and co-founder of Medical Director Co., a nationwide platform that connects aesthetic and wellness professionals with licensed physicians for medical oversight, supervision, and compliance support. With a background that bridges healthcare operations, regulatory compliance, and entrepreneurial growth, Blaz has worked closely with hundreds of nurses, physician assistants, and clinic owners to help them legally launch and scale medical spas, telehealth weight loss clinics, IV hydration businesses, and aesthetic practices.
Blaz holds a degree in finance from Southern Methodist University (SMU) and has built a diverse portfolio of businesses ranging from healthcare to hospitality, including a national network of RV parks and medical clinics. Through MedicalDirector.CO, he’s developed a deep understanding of the state-by-state rules that govern collaborative agreements, PC/MSO structures, telemedicine protocols, and injectable treatments—translating complex legal frameworks into easy-to-implement solutions for clinicians and business owners.
Blaz is particularly passionate about helping nurses and mid-level providers unlock business ownership opportunities, and he’s known for designing systems that streamline operations, boost revenue, and ensure long-term legal protection. His team includes former prosecutors, senior RNs, and physicians who together support a growing number of clinics across all 50 states.
When he’s not working, Blaz enjoys mountain biking, restoring properties, and exploring the outdoors with his wife. He’s based in Texas but works with clients nationwide.
