Best & Worst States for NPs

Yellow trophy against a mint green backdrop

Some people follow their job, moving wherever their position takes them. Others know exactly where they want to live and then find a job that fits their needs. If you’re a nurse practitioner, it doesn’t matter which of these camps you fall into. The latest employment data shows that not only are your skills in high demand across the country, but also that employers are willing to pay very good money to have you work for them. 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:

Salary
Cost of Living
Job Demand/Growth
Quality of Life
Scope of Practice

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've provided you with a high-level summary of the best and worst states for NPs in 2021 across those 5 key metrics. If you want to dig deeper into the data, we've also provided detailed explanations of how each metric was calculated, along with state-by-state rankings for all 50 states.

SUMMARY: The Best & Worst States for Nurse Practitioners in 2021

For your skimming pleasure, here's a high-level summary of the best and worst states for NPs in 2021 across the 5 key metrics.

The Best & Worst States for Nurse Practitioners: Salaries

The 5 Highest-Paying States for Nurse Practitioners
1. California: $138,660/year
2. Washington: $126,920/year
3. Hawaii: $124,000/year
4. New Jersey: $123,810/year
5. Minnesota: $122,850/year
The 5 Lowest-Paying States for Nurse Practitioners
46. South Carolina: $100,680
47. Kansas: $100,550
48. Alabama: $99,570
49. Kentucky: $99,560
50. Tennessee: $96,510

Source: Bureau of Labor Statistics (BLS) - "Occupational Employment and
Wages Data for Nurse Practitioners - May 2019" (Last accessed March 2021)

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

The 5 Most Affordable States for Nurse Practitioners
1. Ohio
2. Oklahoma
3. Michigan
4. Iowa
5. Missouri
The 5 Least Affordable States for Nurse Practitioners
46. Oregon
47. Alaska
48. Massachusetts
49. California
50. Hawaii

Source: U.S. News & World Report - "Best States of 2021 - Affordability Rankings" (Last accessed March 2021)

The Best & Worst States for Nurse Practitioners: Job Growth

The 5 States With the Highest Projected Demand for Nurse Practitioners
1. New York
2. California
3. Texas
4. Florida
5. Illinois
The 5 States With the Lowest Projected Demand for Nurse Practitioners
46. Wyoming
47. Mississippi
48. Nevada
49. Idaho
50. Alaska

Source: ProjectionsCentral.com - "Long-Term Occupational Projections: 2018-2028" (Last accessed March 2021)

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

The 5 Best States for Nurse Practitioners' Quality of Life
1. Washington
2. Minnesota
3. Utah
4. New Hampshire
5. Idaho
The 5 Worst States for Nurse Practitioners' Quality of Life
46. Alabama
47. West Virginia
48. New Mexico
49. Mississippi
50. Louisiana

Source: U.S. News & World Report - "Best States of 2021 Rankings" (Last accessed March 2021)

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

The Best States for Nurse Practitioners: Full Practice Authority
Alaska	Arizona
Colorado	Connecticut
District of Columbia	Hawaii
Idaho	Iowa
Maine	Maryland
Massachusetts	Minnesota
Montana	Nebraska
Nevada	New Hampshire
New Mexico	North Dakota
Oregon	Rhode Island
South Dakota	Vermont
Washington	Wyoming
Delaware	-
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 March 2021)

Nurse Practitioner Salaries: By State

It goes without saying that money is a great motivator, particularly when it comes to making career-related decisions. That said, 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 2019, which the BLS published in May 2020.)

Nurse Practitioner Salaries: State by State

Rank	State	Average Annual Salary for Nurse Practitioners	Average Hourly Pay for Nurse Practitioners
1	California	$138,660	$66.66
2	Washington	$126,920	$61.02
3	Hawaii	$124,000	$59.62
4	New Jersey	$123,810	$59.52
5	Minnesota	$122,850	$59.06
6	New York	$122,550	$58.92
7	Massachusetts	$122,240	$58.77
8	Wyoming	$118,110	$56.78
9	Nevada	$115,970	$55.75
10	Alaska	$115,890	$55.72
11	Texas	$115,440	$55.50
12	Rhode Island	$115,310	$55.44
13	Connecticut	$115,140	$55.36
14	Oregon	$113,430	$54.53
15	Oklahoma	$113,200	$54.42
16	Delaware	$112,430	$54.05
17	Wisconsin	$112,130	$53.91
18	New Mexico	$111,930	$53.81
19	Maryland	$111,800	$53.75
20	Arizona	$111,480	$53.60
21	North Dakota	$110,950	$53.34
22	Idaho	$110,860	$53.30
23	Mississippi	$110,740	$53.24
24	New Hampshire	$110,680	$53.21
25	Iowa	$109,910	$52.84
26	Montana	$109,120	$52.46
27	Virginia	$109,110	$52.46
28	Michigan	$108,660	$52.24
29	Illinois	$107,860	$51.86
30	Maine	$106,960	$51.43
31	Colorado	$106,760	$51.33
32	Indiana	$106,380	$51.14
33	Louisiana	$106,240	$51.08
34	North Carolina	$105,890	$50.91
35	Arkansas	$105,840	$50.88
36	Vermont	$105,840	$50.88
37	Georgia	$105,670	$50.80
38	Nebraska	$105,450	$50.70
39	Utah	$105,240	$50.60
40	Missouri	$105,050	$50.50
41	Ohio	$103,780	$49.89
42	West Virginia	$103,170	$49.60
43	South Dakota	$102,230	$49.15
44	Pennsylvania	$101,950	$49.02
45	Florida	$101,510	$48.80
46	South Carolina	$100,680	$48.41
47	Kansas	$100,550	$48.34
48	Alabama	$99,570	$47.87
49	Kentucky	$99,560	$47.87
50	Tennessee	$96,510	$46.40

Cost of Living for Nurse Practitioners: By State

Of course, no conversation around salary can be complete without also taking into account the cost of living for a given area. While having raw salary data can be helpful to give you a general idea of your earning potential, you'll get a much more realistic picture of your actual income when you understand just how much of it will be going toward living and housing expenses. For example, 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's 2021 Affordability Rankings, which was part of their larger Overall Best States of 2021 ranking (more on this later). To determine how affordable each state was, U.S. News gave them scores on 2 metrics: cost of living and housing affordability. Based on those scores, each state then received an overall ranking on a scale of 1 to 50, with 1 being the most affordable and 50 being the least affordable.

Below, you'll find U.S. News's Affordability rankings for all 50 states, along with their respective scores across the 2 metrics.

2021 Cost of Living Rankings: State by State

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

Demand/Job Growth for Nurse Practitioners: By State

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 52% between 2019 and 2029. (This should translate to about 110,700 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 2028, 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, 2018-2028: State by State

Overall Rank	State	Average Annual Job Openings for Nurse Practitioners	Job Growth Percentage (2018-2028)
1	New York	1,640	41.3%
2	California	1,390	30.5%
3	Texas	1,170	31.9%
4	Florida	1,110	36.9%
5	Illinois	760	31.1%
6	Tennessee	730	34.7%
7	Georgia	660	41.4%
8	Ohio	650	24.6%
9	Pennsylvania	570	26.5%
10	New Jersey	560	28.2%
11	Massachusetts	540	16.2%
12	Washington	480	28.5%
13	Virginia	450	30.7%
14	Indiana	450	29.4%
15	North Carolina	440	30.4%
16	Missouri	420	29.7%
17	Maryland	390	34.9%
18	Michigan	340	16.1%
19	Colorado	330	44.7%
20	Minnesota	330	23.0%
21	Alabama	320	24.2%
22	Kentucky	270	22.3%
23	Wisconsin	250	23.0%
24	Connecticut	240	20.5%
25	Oregon	210	32.0%
26	Arizona	200	50.9%
27	South Carolina	200	25.6%
28	Arkansas	190	31.5%
29	Kansas	190	18.3%
30	Utah	170	34.3%
31	Oklahoma	140	19.4%
32	Iowa	130	30.1%
33	New Hampshire	110	29.9%
34	Maine	110	20.6%
35	West Virginia	100	24.8%
36	New Mexico	90	27.6%
37	Nebraska	90	19.7%
38	Delaware	70	30.8%
39	Montana	60	26.5%
40	Rhode Island	60	14.3%
41	North Dakota	50	31.4%
42	South Dakota	50	27.3%
43	Hawaii	40	23.8%
44	Vermont	40	16.1%
45	Wyoming	30	30.0%
46	Mississippi	30	7.1%
47	Nevada	20	28.6%
48	Idaho	20	24.4%
49	Alaska	20	8.6%
50	Louisiana	No Data Available	No Data Available

Quality of Life for Nurse Practitioners: By State

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’ 2021 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 here.) Below, we've provided you with quality of life rankings for all 50 states, along with their scores for each of the 8 individual metrics.

2021 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	Washington	8	4	4	3	25	6	19	15
2	Minnesota	16	17	15	9	2	21	15	10
3	Utah	11	10	1	5	30	5	8	47
4	New Hampshire	13	13	11	34	3	33	1	2
5	Idaho	24	29	3	10	24	4	10	12
6	Nebraska	28	9	20	6	10	17	31	6
7	Virginia	12	12	13	39	8	18	9	19
8	Wisconsin	15	8	26	24	9	9	25	17
9	Massachusetts	2	2	5	42	36	43	4	4
10	Florida	25	3	8	20	33	8	26	18
11	Vermont	18	15	25	12	17	37	3	9
12	Iowa	20	18	27	19	1	23	14	20
13	North Carolina	30	7	17	22	28	7	20	27
14	North Dakota	27	25	32	4	23	16	18	8
15	South Dakota	29	19	30	14	27	2	35	3
16	Colorado	10	5	2	15	41	45	41	23
17	Maryland	6	14	35	38	15	29	22	11
18	Georgia	43	26	12	11	13	11	29	25
19	New Jersey	4	1	33	41	19	49	5	33
20	Connecticut	3	6	22	46	45	30	6	28
21	New York	7	16	43	30	46	20	11	5
22	Oregon	17	35	14	2	31	13	40	42
23	Delaware	14	24	24	25	14	12	39	45
24	California	5	20	10	31	50	36	28	35
25	Hawaii	1	27	46	33	34	46	12	1
26	Kansas	41	23	31	7	16	39	27	16
27	Maine	26	28	36	37	29	26	2	14
28	Missouri	42	30	23	27	4	15	45	21
29	Tennesse	40	33	16	17	21	3	42	39
30	Illinois	23	11	39	26	12	50	16	43
31	Texas	31	34	9	16	39	10	37	40
32	Indiana	32	22	21	32	7	32	24	48
33	Montana	36	32	19	13	35	19	34	24
34	Rhode Island	9	39	28	49	32	44	7	7
35	Wyoming	38	21	45	8	42	34	21	13
36	Ohio	37	31	34	29	6	24	32	44
37	Nevada	39	40	6	1	47	27	36	50
38	Michigan	35	38	29	35	5	38	30	32
39	Arizona	21	46	7	23	40	40	38	41
40	Pennsylvania	19	37	42	44	11	47	17	38
41	Kentucky	44	36	40	18	20	48	13	29
42	South Carolina	34	44	18	36	38	31	46	26
43	Oklahoma	48	42	37	21	26	25	44	34
44	Arkansas	49	41	41	43	22	14	48	30
45	Alaska	22	49	50	40	43	1	49	46
46	Alabama	45	47	38	28	37	22	43	37
47	West Virginia	47	45	48	50	18	28	23	36
48	New Mexico	33	50	44	45	49	35	47	31
49	Mississippi	50	43	49	48	44	41	33	22
50	Louisiana	46	48	47	47	48	42	50	49

Nurse Practitioner Scope of Practice: By State

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
District of Columbia	Hawaii
Idaho	Iowa
Maine	Maryland
Massachusetts	Minnesota
Montana	Nebraska
Nevada	New Hampshire
New Mexico	North Dakota
Oregon	Rhode Island
South Dakota	Vermont
Washington	Wyoming
Delaware	-
Reduced Practice Authority States
Alabama	Arkansas
Delaware	Indiana
Illinois	Kansas
Kentucky	Louisiana
Mississippi	New Jersey
New York	Ohio
Pennsylvania	Utah
West Virginia	Wisconsin
Restricted Practice Authority States
California	Florida
Georgia	Michigan
Missouri	North Carolina
Oklahoma	South Carolina
Tennessee	Texas
Virginia	—

Originally published on August 23, 2019.
Updated on March 1, 2021.

Image courtesy of iStock.com/Warchi

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These Are the Best & Worst States for Nurse Practitioners