FAQ: What are the different APRN certification options for NPs, CNSs, CNMs, and CRNAs?

Answer: Different certification bodies exist for different APRN roles and population foci. Nurse practitioners can choose between the ANCC, AANPCB, AACN, PNCB, and NCC for their certification, depending on their desired specialization. Clinical nurse specialists can obtain certification through the ANCC or the AACN. Certified nurse midwives must be certified by the AMCB, while certified registered nurse anesthetists must obtain national certification through the NBCRNA.

At present, five organizations provide national certification to nurse practitioners; two of these organizations also provide certifications to clinical nurse specialists. Certified nurse midwives and certified registered nurse anesthetists each have only one organization that provides them with national certification. Depending on their desired population focus, nurse practitioners can earn national certification through the American Nurses Credentialing Center (ANCC), the American Academy of Nurse Practitioners Certification Board (AANPCB), the American Association of Critical Care Nurses (AACN), the Pediatric Nursing Certification Board (PNCB), or the National Certification Corporation (NCC). Clinical nurse specialists can earn national certification through the ANCC or the AACN, and can choose between different types of certifications according to their desired patient population focus. Certified nurse midwives obtain national certification through the American Midwifery Certification Board (AMCB), and certified registered nurse anesthetists must apply for national certification through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

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The Different Certifying Bodies for Advanced Practice Registered Nurses

Advanced Practice Registered Nurses (APRNs), which include nurse practitioners (NPs), clinical nurse specialists (CNSs), certified nurse midwives (CNMs) and certified registered nurse anesthetists (CRNAs), must obtain national certification in their desired specialty before obtaining licensure to practice in their state of residence. While some APRNs, such as CRNAs and CNMs, have only one national certifying body to which they can apply for their national credential, other APRN roles such as NPs and CNSs have multiple certification organizations from which they can choose. To help prospective APRNs better understand their options for national certification in their chosen specialty, we summarized all relevant national certifications for NPs, CNSs, CNMs, and CRNAs, and explain the eligibility requirements for each of these certifications below.

Note: In addition to all of the certification eligibility requirements described below, all individuals who wish to obtain certification from one of the certifying organizations must hold an active an unrestricted RN license in their state of residence.

Nurse Practitioners:

Depending on their patient population focus, nurse practitioners can seek national certification through one of the following organizations: the American Nurses Credentialing Center (ANCC), the American Academy of Nurse Practitioners Certification Board (AANPCB), the American Association of Critical Care Nurses (AACN), the Pediatric Certification Nursing Board (PCNB), and the National Certification Corporation (NCC).

American Nurses Credentialing Center

To qualify for any of the following certifications, nursing students must complete a graduate nursing program that has been accredited by the Accreditation Commission for Education in Nursing (ACEN) or the Commission on Collegiate Nursing Education (CCNE) and complete 500 clinical hours in medical settings that are relevant to their specialization.

During their program, students are required to complete three separate, comprehensive graduate-level courses in advanced physiology/pathophysiology, advanced health assessment, and advanced pharmacology and pharmacotherapeutics. They must also take courses that cover essential concepts in health promotion and maintenance, differential diagnosis and disease management, and the prescription of medications and other treatments. These requirements are consistent with the suggested educational requirements for APRNs outlined in the APRN Consensus Model. Once certified, APRNs must renew their certification every five years. Concentration-specific requirements for the different ANCC certifications are listed below:

• Adult-Gerontology Acute Care NP (AGACNP-BC): Candidates for this certification exam must hold a master’s, doctoral, or post-graduate degree with a focus on adult-gerontology acute care nurse practitioner.
• Adult-Gerontology Primary Care NP (AGPCNP-BC): Nursing students who wish to sit for the AGPCNP certification exam must earn a master’s, doctoral, or post-graduate degree in adult-gerontology primary care nurse practitioner.
• Family NP (FNP-BC): Candidates for this certification exam must hold a master’s, doctoral, or post-graduate degree in family nurse practitioner.
• Pediatric Primary Care NP (PPCNP-BC): Students who wish to sit for the PPCNP certification exam must complete a master’s, doctoral, or post-graduate degree with a focus in pediatric primary care nursing.
• Psychiatric Mental Health NP (PMHNP-BC): To be eligible for the PMHNP certification examination, students must complete a master’s, doctorate, or post-graduate program in psychiatric mental health nursing.
• Emergency Nurse Practitioner (ENP-BC): Candidates for this certification must already hold a master’s, post-graduate, or doctoral degree as well as national certification in one or more of the specializations listed above. This certification does not require an examination, but instead requires candidates to submit a portfolio of work experience that demonstrates a minimum of 2,000 hours of advanced nursing practice in the specialty area of emergency care in the past three years, half of which may be through clinical practicum hours from an emergency care fellowship or residency.

American Academy of Nurse Practitioners Certification Board

As with the ANCC, the AANPCB requires applicants to its certification program to have completed a graduate nursing program that has been accredited by ACEN or CCNE, and which includes classes that cover content outlined in the APRN Consensus Model. Specifically, students must complete three separate, comprehensive courses in advanced health assessment, advanced physiology/pathophysiology, and advanced pharmacology. They must also complete 500 clinical hours in medical settings that are relevant to their population focus. Once certified, NPs must renew their certification every five years. Concentration-specific requirements for the different AANPCB certifications are listed below:

• Family NP: Candidates must complete an accredited graduate nursing program with a focus in family nurse practitioner that fulfills the course content requirements explained above, and includes classes specific to the primary care of individuals across the lifespan.
• Adult-Gerontology Primary Care NP: Candidates must complete an accredited graduate nursing program with a focus in adult-gerontology nurse practitioner that fulfills the coursework requirements outlined above, and includes classes that cover the primary care of adults from adolescence through old age.
• Emergency Care NP: Candidates have three options to qualify for this certification, outlined below:
  • National certification as a Family Nurse Practitioner, combined with the completion of 100 emergency-related continuing education hours (which must include 30 or more credits in emergency procedures) and a minimum of 2,000 hours of direct clinical practice in emergency settings.
  • National certification as a Family Nurse Practitioner, combined with the completion of a graduate or post-graduate nursing program in emergency care advanced practice nursing.
  • National certification as a Family Nurse Practitioner, combined with the completion of an approved advanced practice fellowship program in emergency nursing care.

The American Association of Critical Care Nurses

The AACN offers an Adult-Gerontology Acute Care Nurse Practitioner certification exam and credential (ACNPC-AG), the requirements for which are the completion of a CCNE or ACEN-accredited graduate nursing program in adult-gerontology acute care that covers advanced physical assessments, physiology and pathophysiology, and pharmacology, as well as the legal and ethical implications of acute care nursing. The program must also include 500 supervised clinical practicum hours in acute care settings, working with adult and geriatric patients. As with the ANCC and the AANPCB, APRNs must renew their AACN certification every five years.

The Pediatric Nursing Certification Board

The PNCB provides national certifications for pediatric nurse practitioners in the areas of acute care and primary care. The eligibility requirements to sit for the certification exam in either population focus are outlined below.

• Certified Pediatric Primary Care NP (CPNP-PC): To be eligible for certification, nursing students must complete a CCNE or ACEN-accredited graduate nursing program in pediatric primary care. Their program must include 500 hours of supervised clinical practicum hours in primary care pediatrics, as well as course content in advanced physiology and pathophysiology, advanced health assessment, and advanced pharmacology, in accordance with the APRN Consensus Model.
• Certified Pediatric Acute Care NP (CPNP-AC): To be eligible for certification, nursing students must complete a CCNE or ACEN-accredited graduate nursing program in pediatric acute care. Their program must include 500 hours of supervised clinical practicum hours in acute care pediatrics, and comprehensively cover advanced physiology and pathophysiology, advanced health assessment, and advanced pharmacology, in accordance with the APRN Consensus Model.

The National Certification Corporation

The national certification corporation provides certifications for advanced practice women’s health nursing and neonatal nursing. The requirements for these certifications are outlined below.

• Women’s Health NP (WHNP-BC): Candidates for the WHNP certification exam must complete a master’s, DNP, or post-master’s program with a focus in women’s health nurse practitioner that has been accredited by either the CCNE or ACEN. 200 hours of this program must be didactic, and 600 hours of it must be clinical, and students must take the WHNP certification examination within 8 years of completing their graduate program.
• Neonatal Nurse Practitioner (NNP-BC): Candidates for the NNP certification exam must complete a master’s, DNP, or post-master’s program with a focus in neonatal nurse practitioner that has been accredited by either the CCNE or ACEN. 200 hours of this program must be didactic, and 600 hours of it must be clinical, and students must take the NNP certification examination within 8 years of graduating from their graduate nursing program.

Clinical Nurse Specialists

Clinical nurse specialists can seek national certification through the ANCC or the AACN. Below is a detailed explanation of the CNS certifications available through both organizations.

American Nurses Credentialing Center

The ANCC provides an Adult-Gerontology Clinical Nurse Specialist certification. To be eligible to sit for this certification examination, individuals must have completed a master’s, doctoral, or post-graduate degree with a concentration in adult-gerontology clinical nurse specialist from a program that has been accredited by the CCNE or ACEN. This program must include a minimum of 500 supervised clinical practicum hours in the adult-gerontology clinical nurse specialist role, as well as content around advanced physiology and pathophysiology, advanced health assessment, advanced pharmacology, health promotion, and methods of differential diagnoses and disease management.

The ANCC offered four other CNS certifications that it is now retiring: Adult Health CNS, Adult Psychiatric-Mental Health CNS, Child/Adolescent Psychiatric-Mental Health CNS, and Pediatric CNS. The retirement of these certifications is due to an effort on the part of the ANCC to align their certifications with the recommendations of the APRN Consensus Model. The ANCC accepted the last applications for these four retiring certifications in December of 2016, and are allowing individuals who have registered for these certification exams to take them no later than October 31, 2017. Starting in November of 2017, individuals holding one of these four credentials may renew their certifications if they continually meet professional development and practice requirements.

American Association of Critical Care Nurses

The AACN offers certifications in Adult-Gerontology Clinical Nurse Specialist, Pediatric Clinical Nurse Specialist, and Neonatal Clinical Nurse Specialist. Below are the requirements for each of these specializations, which align with the requirements outlined in the APRN Consensus Model and meet the standards of the National Council of State Boards of Nursing (NCSBN).

• Acute Care Clinical Nurse Specialist in Adult-Gerontology (ACCNS-AG): To be eligible to sit for the ACCNS-AG certification exam, candidates must complete a graduate nursing program with a concentration in adult-gerontology CNS that has been accredited by the CCNE or ACEN. The program’s curriculum must include courses that cover advanced physical assessment, physiology and pathophysiology, and pharmacology, as well as a minimum of 500 supervised clinical practicum hours in adult-gerontology acute care settings.
• Acute Care Clinical Nurse Specialist in Pediatric (ACCNS-P): In order to sit for the ACCNS-P examination, candidates must complete a graduate nursing program with a concentration in pediatric CNS that has been accredited by the CCNE or ACEN. The program’s curriculum must have courses in advanced health assessment, as well as advanced physiology, pathophysiology, and pharmacology. It must also include at least 500 supervised clinical practicum hours in pediatric acute care settings.
• Acute Care Clinical Nurse Specialist in Neonatal (ACCNS-N): To sit for the ACCNS-N certification exam, candidates must complete a CCNE or ACEN-accredited graduate nursing program with a focus in neonatal CNS. The curriculum of this program must cover advanced physiology, pathophysiology, and pharmacology, as well as advanced health assessment. It must also include 500 or more clinical practicum hours in neonatal care settings.

Certified Nurse Midwives

CNMs are certified through the American Midwifery Certification Board (AMCB). Candidates for the AMCB’s certification examination must have completed a graduate degree with a concentration in nurse midwifery from a program that has been accredited by or which has received pre-accreditation status from the Accreditation Commission for Midwifery Education (ACME). Candidates must send the AMCB verification that they have completed an ACME-accredited degree program, or met the institutional requirements for such a program, through a letter from the director of their program. For more information about the process for obtaining certification as a CNM through the AMCB, refer to the AMCB Certification Exam Candidate Handbook.

Certified Registered Nurse Anesthetists

CRNAs are nationally certified through the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA). To be eligible to sit for the NBCRNA’s National Certification Examination (NCE), candidates must complete a nurse anesthesia graduate program that has been accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). The NBCRNA’s requirements for candidates taking the examination vary depending on the degree they are pursuing and their time of enrollment.

Candidates who are enrolled in a nurse anesthesia master’s degree program on or before January 1, 2015 must complete the following academic requirements:

• Three comprehensive graduate-level classes in advanced health assessment, advanced physiology and pathophysiology, and advanced pharmacology
• 135 hours of human anatomy, physiology, and pathophysiology
• 105 hours of pharmacology coursework covering anesthetic agents and adjuvant drugs, including their chemistry and biochemistry
• 45 hours of course content covering professional elements of nurse anesthesia practice
• 105 hours in basic and advanced principles of anesthesia practice including the technology, equipment, and physics of the practice, and palliative care principles
• 30 hours of research
• 45 hours of clinical correlation conferences
• Courses in radiology and ultrasound (no minimums for either field)

Candidates who are enrolled in a nurse anesthesia doctoral degree program on or before January 1, 2015 must complete the following academic requirements:

• 120 hours of advanced physiology and pathophysiology
• 90 hours of advanced pharmacology
• 45 hours of advanced health assessment
• 120 hours of basic and advanced principles in nurse anesthesia
• 75 hours or research
• Courses in the following subjects (no minimum hours requirements):
  • Human Anatomy
  • Chemistry, Biochemistry, and Physics
  • Genetics
  • Palliative Care for Acute and Chronic Pain
  • Radiology and Ultrasound
  • Anesthesia Equipment
  • Professional Role Development
  • Chemical Dependency
  • Nursing Informatics
  • Ethics and Multiculturalism in Healthcare
  • Nursing Leadership and Management
  • Business and Management Principles in Anesthesia Practice
  • Health Policy
  • Healthcare Finance
  • Clinical Correlation and Integration

In addition to the academic requirements outlined above, and regardless of whether they are pursuing a master’s or a doctoral degree, candidates for the NCE must complete 2000 clinical hours of anesthesia work, divided over 600 different patient cases. The NBCRNA has specific requirements regarding the types of clinical cases nursing students must complete, which include trauma/emergency situations, obstetrical management, and palliative care, and what types of equipment they must use in their work with patients.

Candidates for NBCRNA certification should note that if they enrolled in a CRNA graduate program on or before December 31, 2014, they must fulfill slightly different requirements in order to be eligible for the NCE. For more details on NCE eligibility requirements, please refer to the NBCRNA’s NCE Handbook.