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These Are the Best & Worst States for Nurse Practitioners (NPs)

Nov 14, 2025

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Best states for nurse practitioners to practice

The best states for nurse practitioners can seem relative. If your needs are met and you’re happy, your state might be the best for you. But some NPs might job search based on industry data that reveal some of the factors that qualify a state as being “the best.” And we’ve gathered some info that could help.

The latest employment data, referenced in this article, show that not only are nurse practitioner skills in high demand across the country but the lowest median salary is over $100,000, and job growth rates for NPs are increasing everywhere. Even better? More states are granting NPs full practice authority. Now, the only question you need to answer is: do you stay where you are, or do you move someplace else?

To help you figure this out, we collected data and rankings for each state along 5 metrics that play a key role in an NP’s professional and personal lives:

Together, all these pieces of information can help give you a better idea of what states would be most ideal for you to live and work, based on your priorities and preferences.

Below, we provide you with a high-level summary of the best and worst states for NPs in 2026 across those five key metrics. If you want to dig deeper into the data, we also provide detailed explanations of how each metric was calculated, along with state-by-state rankings for all 50 states.

See full state-by-state rankings.

SUMMARY: The Best & Worst States for Nurse Practitioners in 2026

For your skimming pleasure, here’s a high-level summary of the best and worst states for NPs in 2026 across the five key metrics.

The Best & Worst States for Nurse Practitioners: Salaries

The 5 Highest-Paying States for Nurse Practitioners
1. California: $173,190
2. New York: $148,410
3. Oregon: $148,030
4. Massachusetts: $145,140
5. Washington: $143,620

The 5 Lowest-Paying States for Nurse Practitioners
46. Kentucky: $116,930
47. Arkansas: $116,030
48. South Carolina: $113,950
49. Alabama: $109,650
50. Tennessee: $108,180
Source: Bureau of Labor Statistics (BLS), “Occupational Employment and Wage Statistics (Nurse Practitioners),” May 2023 (last accessed October 2025).

The Best & Worst States for Nurse Practitioners: Cost of Living

The 5 Most Affordable States for Nurse Practitioners
1. Arkansas
2. Mississippi
3. West Virginia
4. South Dakota
5. Oklahoma

The 5 Least Affordable States for Nurse Practitioners
46. Washington
47. Massachusetts
48. Hawaii
49. New Jersey
50. California
Source: U.S. News & World Report, “Best States of 2025 – Affordability Rankings” (last accessed October 2025).

The Best & Worst States for Nurse Practitioners: Job Growth

The 5 States With the Highest Projected Demand for Nurse Practitioners
1. California
2. Texas
3. Florida
4. Tennessee
5. New York

The 5 States With the Lowest Projected Demand for Nurse Practitioners
46. Vermont
47. North Dakota
48. Hawaii
49. Wyoming
50. Alaska
Source: ProjectionsCentral.com, “Long-Term Occupational Projections: 2022–2032” (last accessed October 2025).

The Best & Worst States for Nurse Practitioners: Quality of Life

The 5 Best States for Nurse Practitioners’ Quality of Life
1. Utah
2. New Hampshire
3. Idaho
4. Minnesota
5. Nebraska

The 5 Worst States for Nurse Practitioners’ Quality of Life
46. West Virginia
47. New Mexico
48. Mississippi
49. Alaska
50. Louisiana
Source: U.S. News & World Report, “Best States of 2025 Rankings” (last accessed October 2025).

The Best & Worst States for Nurse Practitioners: Scope of Practice

The Best States for Nurse Practitioners: Full Practice Authority
Alaska Arizona
Colorado Connecticut
Delaware District of Columbia
Hawaii Idaho
Iowa Kansas
Maine Maryland
Montana Nebraska
Nevada New Hampshire
New Mexico New York
North Dakota Oregon
Rhode Island South Dakota
Utah Vermont
Washington Wyoming

The Worst States for Nurse Practitioners: Restricted Practice Authority States
California Florida
Georgia Michigan
Missouri North Carolina
Oklahoma South Carolina
Tennessee Texas
Virginia —

Source: American Association of Nurse Practitioners (AANP), “State Practice Environment” (last accessed October 2025).

female nurse holding a clipboard looking out a window

Best States for Nurse Practitioners: By Salary

It goes without saying that money is a great motivator, particularly when it comes to making career-related decisions. That said, nurse practitioner salaries tend to vary (and sometimes significantly) from state to state. To show you what your earning potential could be in each state, we’ve shared the latest BLS salary data for NPs below. (Keep in mind that all BLS data reflects the employment and wage numbers for NPs as of May 2024.)

Note that we excluded Nevada because BLS didn’t have salary estimates available for the state.

Nurse Practitioner Salaries: State by State

Rank

State

Average Annual Salary for Nurse Practitioners

Average Hourly Pay for Nurse Practitioners
1 California $173,190 $83.26
2 New York $148,410 $71.35
3 Oregon $148,030 $71.17
4 Massachusetts $145,140 $69.78
5 Washington $143,620 $69.05
6 Alaska $142,340 $68.43
7 Connecticut $141,140 $67.85
8 New Jersey $140,470 $67.54
9 Rhode Island $139,600 $67.11
10 New Mexico $136,620 $65.68
11 Hawaii $135,020 $64.91
12 New Hampshire $133,660 $64.26
13 Iowa $133,020 $63.95
14 Arizona $132,920 $63.90
15 Utah $131,680 $63.31
16 Montana $131,560 $63.25
17 Idaho $131,380 $63.16
18 Texas $130,930 $62.95
19 Vermont $130,580 $62.78
20 Wisconsin $130,490 $62.74
21 Delaware $130,190 $62.59
22 Illinois $128,880 $61.96
23 Florida $128,340 $61.70
24 Minnesota $128,120 $61.60
25 Nebraska $127,950 $61.51
26 Kansas $127,900 $61.49
27 Maine $127,750 $61.42
28 Colorado $127,610 $61.35
29 Michigan $127,200 $61.15
30 Oklahoma $127,120 $61.12
31 Maryland $127,100 $61.11
32 Pennsylvania $126,730 $60.93
33 Indiana $126,520 $60.83
34 Wyoming $126,060 $60.60
35 Georgia $125,490 $60.33
36 Louisiana $124,850 $60.02
37 North Carolina $124,830 $60.01
38 Missouri $124,600 $59.90
39 Mississippi $122,930 $59.10
40 South Dakota $122,300 $58.80
41 Virginia $122,180 $58.74
42 West Virginia $122,140 $58.72
43 Ohio $121,250 $58.29
44 North Dakota $121,200 $58.27
45 Kentucky $116,930 $56.22
46 Arkansas $116,030 $55.79
47 South Carolina $113,950 $54.79
48 Alabama $109,650 $52.72
49 Tennessee $108,180 $52.01

women sitting around a table outside talking

Best States for Nurse Practitioners: By Cost of Living

Of course, no conversation around salary can be complete without also taking into account the cost of living for a given area.

If you have a high-paying job in a state that tends to have a very high cost of living, then you would expect to see most (if not all) of your paycheck going toward your living expenses. But, if you had an average salary in a state with a low cost of living, you’d be more likely to have some money left over to spend however you wanted.

To help you get a better picture of your earning potential in different states, we turned to U.S. News’ 2025 Affordability Rankings, part of its larger Overall Best States of 2025 ranking (more on this later).

To determine how affordable each state was, U.S. News gave them scores on two metrics: cost of living and housing affordability. Below, you’ll find U.S. News’ Affordability rankings for all 50 states, with 1 being the most affordable, and 50 being the least. along with their respective scores across the two metrics.

2025 Cost of Living Rankings: State by State

Overall Rank

State

Cost of Living Score

Housing Affordability Score
1 Arkansas 1 3
2 Mississippi 2 1
3 West Virginia 8 2
4 South Dakota 3 6
5 Oklahoma 4 7
6 Louisiana 5 8
7 Iowa 7 9
8 Alabama 10 4
9 North Dakota 6 11
10 Kentucky 14 5
11 Kansas 9 10
12 Nebraska 12 15
13 New Mexico 13 16
14 Missouri 17 12
15 Montana 11 18
16 Ohio 18 14
17 Wyoming 15 17
18 Indiana 19 13
19 Tennessee 20 19
20 Wisconsin 21 20
21 Idaho 16 27
22 South Carolina 22 23
23 Michigan 24 21
24 North Carolina 23 24
25 Vermont 26 25
26 Maine 29 22
27 Georgia 27 28
28 Pennsylvania 31 26
29 Minnesota 32 29
30 Texas 30 32
31 Utah 25 36
32 Illinois 33 30
33 Delaware 34 33
34 Nevada 28 39
35 Alaska 39 31
36 Rhode Island 38 34
37 Virginia 35 35
38 Arizona 36 37
39 Oregon 43 38
40 Connecticut 41 41
41 Maryland 42 42
42 New Hampshire 44 40
43 Colorado 37 48
44 Florida 40 44
45 New York 45 43
46 Washington 47 45
47 Massachusetts 46 47
48 Hawaii 48 46
49 New Jersey 49 49
50 California 50 50

Best States for Nurse Practitioners: By Demand/Job Growth

The more job openings there are, the greater the need there is for a specific profession. This is particularly true for NPs, who should expect to see the number of available jobs increase by about 35% by 2034. (This should translate to about 134,000 new jobs opening up during that time.)

The only problem is that this significant job growth won’t be spread equally across the U.S. Naturally, some states will see higher rates of job growth than others. Below, we’ve shared occupational projection numbers from Projections Central to show you how much demand there will be for NPs on a state-by-state basis between now and 2032, both in terms of raw job opening numbers and job growth percentage.

You’ll notice that there are some two-way ties in the number of job openings. Within those tied pairs, we ranked them based on who had the higher job growth percentage.

Projected Job Demand for Nurse Practitioners, 2022–2032: State by State

Overall Rank

State

Average Annual Job Openings

Job Growth Percentage (2022–2032)
1 Arizona 860 71.1%
2 New Mexico 200 64.8%
3 Arkansas 360 61.3%
4 South Carolina 490 60.7%
5 Utah 430 60.3%
6 Idaho 110 60%
7 Texas 2240 60%
8 California 2500 58.6%
9 Florida 2190 58.5%
10 Georgia 910 58.2%
11 Tennessee 1570 57.9%
12 Colorado 420 56.2%
13 South Dakota 90 56.1%
14 Virginia 800 55.6%
15 North Carolina 920 55.5%
16 Montana 110 55.2%
17 Delaware 110 55%
18 Iowa 260 52.9%
19 Oregon 240 52.7%
20 West Virginia 180 52.3%
21 Nevada 200 51.1%
22 Wisconsin 530 51.1%
23 New Hampshire 160 50.7%
24 New Jersey 720 50.7%
25 Alabama 480 50%
26 Hawaii 50 48.9%
27 North Dakota 60 48.3%
28 Wyoming 50 47.9%
29 Massachusetts 280 46.9%
30 Indiana 660 45.8%
31 Kentucky 470 45.2%
32 Rhode Island 140 45.1%
33 Washington 600 45.1%
34 Connecticut 310 44.8%
35 Minnesota 550 43.8%
36 Louisiana 440 43.6%
37 Kansas 310 42.9%
38 Pennsylvania 770 42.7%
39 Mississippi 400 42.6%
40 Ohio 1060 42.6%
41 Maryland 500 42.2%
42 Missouri 720 41.9%
43 Michigan 700 41.2%
44 Illinois 850 41.1%
45 Oklahoma 280 38.6%
46 Nebraska 160 35.8%
47 Vermont 70 35.8%
48 Maine 120 35.3%
49 New York 440 26.3%
50 Alaska 30 10%

woman walking a small child through the park

Best States for Nurse Practitioners: By Quality of Life

Once we got a better understanding of what each state could offer NPs as far as earning potential, job growth, and cost of living, we decided to find out the kind of quality of life NPs could expect to have in each area. To do this, we turned to U.S. News’ 2025 Best States Rankings, which considered a whole host of natural and social environment factors on a state-by-state basis. They determined each state’s rank by first scoring them along the following 8 metrics:

  • Healthcare
  • Education
  • Economy
  • Infrastructure
  • Opportunity
  • Fiscal Stability
  • Crime & Corrections
  • Natural Environment

The scores were on a scale of 1 to 50, with 1 being the best and 50 best the worst. They then used those scores to provide an overall ranking for each state. (You can read more about their methodology.) Below, we’ve provided you with quality-of-life rankings for all 50 states, along with their scores for each of the eight individual metrics.

2025 Quality of Life Rankings: State by State

Overall Rank

State

Healthcare Score

Education Score

Economy Score

Infrastructure Score

Opportunity Score

Fiscal Stability Score

Crime & Corrections Score

Natural Environment Score
1 Utah 14 4 3 3 19 1 7 48
2 New Hampshire 12 16 12 19 6 37 1 4
3 Idaho 20 29 4 16 10 8 9 10
4 Minnesota 16 11 28 10 7 13 16 14
5 Nebraska 23 13 29 1 14 6 18 11
6 Florida 21 2 1 15 47 9 13 12
7 Vermont 19 23 15 9 1 41 4 9
8 South Dakota 46 8 13 2 12 10 34 5
9 Massachusetts 2 5 11 39 41 36 5 3
10 Washington 15 9 23 7 40 16 33 7
11 Colorado 9 3 6 11 33 43 47 16
12 North Dakota 31 28 17 8 4 17 28 17
13 North Carolina 25 12 7 32 18 14 25 26
14 Iowa 27 20 44 14 2 4 14 29
15 Connecticut 3 10 8 27 43 48 8 15
16 Virginia 18 15 10 38 25 23 12 19
17 Wisconsin 26 7 27 31 9 18 27 25
18 Delaware 10 35 21 21 15 2 32 42
19 New Jersey 5 1 31 12 45 49 10 28
20 Maryland 6 21 35 28 27 27 30 2
21 Georgia 37 27 18 13 32 5 22 20
22 New York 8 17 41 34 9 3 24 6
23 Wyoming 39 6 22 26 21 30 23 13
24 Rhode Island 4 38 16 45 24 45 6 8
25 Kansas 33 18 34 6 5 32 35 43
26 Montana 42 22 20 25 13 19 37 27
27 Maine 28 40 30 40 3 29 2 22
28 Hawaii 1 26 48 49 34 40 3 1
29 Texas 32 25 2 18 48 12 40 46
30 Arizona 13 42 5 17 44 35 26 38
31 Missouri 43 33 25 37 11 11 43 18
32 Tennessee 41 31 24 23 22 7 45 34
33 Indiana 35 19 40 20 16 33 21 50
34 Nevada 36 37 9 4 38 28 41 47
35 Oregon 17 41 37 5 39 22 44 44
36 Illinois 24 14 42 22 35 50 15 45
37 California 7 24 32 35 50 42 38 24
38 Ohio 34 30 39 30 17 25 31 41
39 Kentucky 45 32 46 24 20 34 11 23
40 South Carolina 30 43 14 36 42 20 42 21
41 Pennsylvania 11 39 38 43 29 39 17 40
42 Oklahoma 48 48 19 29 30 21 36 37
43 Michigan 22 45 33 44 23 38 39 32
44 Arkansas 47 36 26 41 28 15 48 35
45 Alabama 40 44 36 33 26 31 29 33
46 West Virginia 49 47 47 50 8 24 19 36
47 New Mexico 38 50 43 42 37 26 49 30
48 Mississippi 50 34 49 47 31 47 20 31
49 Alaska 29 49 45 46 36 44 46 39
50 Louisiana 44 46 50 48 46 46 50 49

Best States for Nurse Practitioners: By Scope of Practice

Practice authority is the amount of restriction and oversight an NP needs to practice in any given state — and each state’s laws and regulations will differ. The American Association of Nurse Practitioners (AANP) categorizes state practice environments into three groups:

  • Full Practice Authority: According to the AANP, “State practice and licensure laws permit all NPs to 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. This is the model recommended by the National Academy of Medicine, formerly called the Institute of Medicine, and the National Council of State Boards of Nursing.” These are the best states for NPs looking to open their own practice.
  • Reduced Practice Authority: “State practice and licensure laws reduce the ability of NPs to engage in at least one element of NP practice. State law requires a career-long regulated collaborative agreement with another health provider in order for the NP to provide patient care, or it limits the setting of one or more elements of NP practice.”
  • Restricted Practice Authority: “State practice and licensure laws restrict the ability of NPs to engage in at least one element of NP practice. State law requires career-long supervision, delegation or team management by another health provider in order for the NP to provide patient care.”

Currently, most U.S. states give NPs full practice authority, but there are still a considerable number that don’t. Here’s how it breaks down:

The Best & Worst States for Nurse Practitioners’ Scope of Practice

Full Practice Authority States
Alaska Arizona
Colorado Connecticut
Delaware District of Columbia
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

Reduced Practice Authority States
Alabama Arkansas
Illinois Indiana
Kentucky Louisiana
Kentucky Louisiana
Mississippi New Jersey
Ohio Pennsylvania
West Virginia Wisconsin

Restricted Practice Authority States
California Florida
Georgia Michigan
Missouri North Carolina
Oklahoma South Carolina
Tennessee Texas
Virginia —

Overall Best & Worst States to Work as a Nurse Practitioner

Here is an aggregated list of the overall best and worst states for nurse practitioners based on all the key points discussed above.

State

Affordability (Overall)

Salary (Annual Mean Wage)

Quality of Life

Job Demand (% Growth)

Practice Authority
Alabama #08 $109,650 #45 50.00% Reduced
Alaska #35 $142,340 #49 10.00% Full
Arizona #38 $132,920 #30 71.10% Full
Arkansas #01 $116,030 #44 61.30% Reduced
California #50 $173,190 #37 58.60% Restricted
Colorado #43 $127,610 #11 56.20% Full
Connecticut #40 $141,140 #15 44.80% Full
Delaware #33 $130,190 #18 55.00% Full
Florida #44 $128,340 #06 58.50% Restricted
Georgia #27 $125,490 #21 58.20% Restricted
Hawaii #48 $135,020 #28 48.90% Full
Idaho #21 $131,380 #03 60.00% Full
Illinois #32 $128,880 #36 41.10% Reduced
Indiana #18 $126,520 #33 45.80% Reduced
Iowa #07 $133,020 #14 52.90% Full
Kansas #11 $127,900 #25 42.90% Full
Kentucky #10 $116,930 #39 45.20% Reduced
Louisiana #06 $124,850 #50 43.60% Reduced
Maine #26 $127,750 #27 35.30% Full
Maryland #41 $127,100 #20 42.20% Full
Massachusetts #47 $145,140 #09 46.90% Full
Michigan #23 $127,200 #43 41.20% Restricted
Minnesota #29 $128,120 #04 43.80% Full
Mississippi #02 $122,930 #48 42.60% Reduced
Missouri #14 $124,600 #31 41.90% Restricted
Montana #15 $131,560 #26 55.20% Full
Nebraska #12 $127,950 #05 35.80% Full
Nevada #34 No Salary Data Available #34 51.10% Full
New Hampshire #42 $133,660 #02 50.70% Full
New Jersey #49 $140,470 #19 50.70% Reduced
New Mexico #13 $136,620 #47 64.80% Full
New York #45 $148,410 #22 26.30% Full
North Carolina #24 $124,830 #13 55.50% Restricted
North Dakota #09 $121,200 #12 48.30% Full
Ohio #16 $121,250 #38 42.60% Reduced
Oklahoma #05 $127,120 #42 38.60% Reduced
Oregon #39 $148,030 #35 52.70% Full
Pennsylvania #28 $126,730 #41 42.70% Restricted
Rhode Island #36 $139,600 #24 45.10% Full
South Carolina #22 $113,950 #40 60.70% Restricted
South Dakota #04 $122,300 #08 56.10% Full
Tennessee #19 $108,180 #32 57.90% Restricted
Texas #30 $130,930 #29 60.00% Restricted
Utah #31 $131,680 #01 60.30% Full
Vermont #25 $130,580 #07 35.80% Full
Virginia #37 $122,180 #16 55.60% Restricted
Washington #46 $143,620 #10 45.10% Full
West Virginia #03 $122,140 #46 52.30% Reduced
Wisconsin #20 $130,490 #17 51.10% Reduced
Wyoming #17 $126,060 #23 47.90% Full

Methodology and Sources

To arrive at our results, we pulled the latest available data from four sources: the Bureau of Labor Statistics Occupational Employment and Wage Statistics Query System (2024), U.S. News Affordability and Best States rankings (2025), American Association of Nurse Practitioners Practice Map (2025), and the Projections Central database (2022–2032).

Here’s the data we got from each source:

  • BLS Query System: Average annual salaries
  • U.S. News Affordability rankings: Affordability of living in each state, calculated based on cost of living and housing affordability
  • U.S. News Best States rankings: Best states to live in overall, determined by crime, education, healthcare, environment, economy, fiscal stability, infrastructure, and opportunity
  • Projections Central: Projected job growth percentages
  • AANP Practice Authority Map: Scope of practice allowed in each state

Getting NP Malpractice Insurance Wherever You Work

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Last updated on Nov 14, 2025.
Originally published on Mar 01, 2021.

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