(a)  Prior to the performance of any medical acts, a nurse practitioner shall:

(1)           meet registration requirements as specified in 21 NCAC 36 .0803;

(2)           submit an application for approval to practice;

(3)           submit any additional information necessary to evaluate the application as requested; and

(4)           have a collaborative practice agreement with a primary supervising physician.

(b)  A nurse practitioner seeking approval to practice who has not practiced as a nurse practitioner in more than two years shall complete a nurse practitioner refresher course approved by the Board of Nursing in accordance with Paragraphs (o) and (p) of 21 NCAC 36 .0220 and consisting of common conditions and their management directly related to the nurse practitioner's area of education and certification. A nurse practitioner refresher course participant shall be granted an approval to practice that is limited to clinical activities required by the refresher course.

(c)  The nurse practitioner shall not practice until notification of approval to practice is received from the Board of Nursing after both Boards have approved the application.

(d)  The nurse practitioner's approval to practice is terminated when the nurse practitioner discontinues working within the approved nurse practitioner collaborative practice agreement, or experiences an interruption in her or his registered nurse licensure status, and the nurse practitioner shall so notify the Board of Nursing in writing. The Boards shall extend the nurse practitioner's approval to practice in cases of emergency such as injury, sudden illness or death of the primary supervising physician.

(e)  Applications for approval to practice in North Carolina shall be submitted to the Board of Nursing and then approved by both Boards as follows:

(1)           the Board of Nursing shall verify compliance with Rule .0803 and Paragraph (a) of this Rule; and

(2)           the Medical Board shall verify that the designated primary supervising physician holds a valid license to practice medicine in North Carolina and compliance with Paragraph (a) of this Rule.

(f)  Applications for approval of changes in practice arrangements for a nurse practitioner currently approved to practice in North Carolina shall be submitted by the applicant as follows:

(1)           addition or change of primary supervising physician shall be submitted to the Board of Nursing and processed pursuant to protocols developed by both Boards; and

(2)           request for change(s) in the scope of practice shall be submitted to the Joint Subcommittee.

(g)  A registered nurse who was previously approved to practice as a nurse practitioner in this state who reapplies for approval to practice shall:

(1)           meet the nurse practitioner approval requirements as stipulated in Rule .0808(c) of this Section; and

(2)           complete the appropriate application.

(h)  Volunteer Approval to Practice. The North Carolina Board of Nursing shall grant approval to practice in a volunteer capacity to a nurse practitioner who has met the qualifications to practice as a nurse practitioner in North Carolina.

(i)  The nurse practitioner shall pay the appropriate fee as outlined in Rule .0813 of this Section.

(j)  A Nurse Practitioner approved under this Section shall keep proof of current licensure, registration and approval available for inspection at each practice site upon request by agents of either Board.


History Note:        Authority G.S. 90-18(13), (14); 90-18.2; 90-171.20(7); 90-171.23(b);

Recodified from 21 NCAC 36 .0227(c) Eff. August 1, 2004;

Amended Eff. November 1, 2013; January 1, 2013; December 1, 2009; November 1, 2008; January 1, 2007; August 1, 2004;

Readopted Eff. January 1, 2019.