UP FRONT
APP Perspectives
Continued from page 22
TABLE.
Who Are They, and What Do They Do?
Title and Certifications
Credentials/
Certifying Organization
How Were They Trained?
What Do They Do?
Master’s degree (usually at least 2-3 years)
with certification, or “grandfathered” in by
certification, to allow authority to practice
and prescribe
A CNP is a licensed APRN who has completed a prescribed educational program that
includes advanced knowledge, skills, and abilities in assessment, diagnosis, treatment, and management. Most CNPs can prescribe and maintain independent practices.
Eighteen states allow APRNs “full practice authority” to diagnose and treat without
physician involvement.*
Master’s degree with certification to allow
the authority to practice and prescribe
Similar to a CNP, but a CNS’s education focuses on a defined field of study (such as perinatal nursing, infectious disease nursing, education, or cardiovascular nursing). CNSs
are trained to become clinical experts in their field and base their practice on research
and theory. Many states allow certified nurses to diagnose and prescribe.
Master’s degree or by certification
PAs are similar to CNPs, but they trained in the medical model rather than nursing
domain. There has been a distribution shift (females > males) and 62% of all female
PAs are under 40 years of age; 37.6% of all male PAs are under 40 years.12
Certified Nurse Practitioner (CNP)
Advanced Practice Registered Nurse
(APRN)
Advanced Practice Nurse (APN)
American Nurses Credentialing
Center
American Academy of Nurse
Practitioners (AANP)
Nurse Practitioner (NP)
Clinical Nurse Specialist (CNS)
Adult Health Clinical Nurse Specialist
(AHCNS)
Physician Assistant (PA)
American Nurses Credentialing
Center (ACNS-BC)
National Commission on Certification of Physician Assistants
(PA-C)
Master of Physician Assistant
Studies (MPAS)
Doctor of Nursing Science
DNSc
Nursing Doctorate
ND
Doctor of Science in Nursing
Focused in clinical practice (rather than
research, as with PhD)
These degrees are replaced by newer DNPs, and curricula have been revised to provide
consistent education and ability to practice as NP. Not all DNSc, NDs, or DSNs can
practice as NP or CNS without additional certification.
DSN
Doctor of Nursing Practice
DNP
Doctorate focused in clinical practice (rather
than research, as with PhD) with certification to allow the authority to practice and
prescribe
Doctor of Philosophy in Nursing or PA
Science
PhD
Doctorate focused on research/scholarship
Not all PhDs will practice as NPs or PAs unless a certification has been obtained through
an accredited body (usually ANCC, NCCPA).
Licensed Independent Practitioner
(LIP) or Certified Healthcare Practitioner (CHP)
MD, DO, NP, CNS, PA, DDS, OD,
CNM, CRNA
Any physician, dentist, nurse practitioner,
and nurse midwife or any other
An LIP is an individual permitted by law and the organization to provide care and
services without direction or supervision, within the scope of the individual’s license and
consistent with individually granted clinical privileges.
CNP, CNS, PA, CNM, CRNA
Pursuant to Title 21, Code of Federal Regulations, Section 1300.01(b28)
MLP refers to an individual practitioner – other than a physician, dentist, veterinarian,
or podiatrist – who is licensed, registered, or otherwise permitted by the United States
or the jurisdiction in which he/she practices, to dispense a controlled substance in the
course of professional practice.**
Mid-level Practitioner (MLP)
DNPs function similarly to NPs but they have an advanced research education.
Source: Clarification of Credentialing & Privileging Policy Outlined in Policy Information Notice 2001-16 (effective 2002-2022). Accessed from: http://bphc.hrsa.gov/policiesregulations/policies/pdfs/pin200222.pdf
*Full practice states without physician involvement: AL, AZ, CO, DC, HI, ID, IA, ME, MT, NH, NM, ND, NV, OR, RI, VT, WA, WY
** Mid-level practitioners per state. Accessed from: www.deadiversion.usdoj.gov/drugreg/practioners/mlp_by_state.pdf
across the United States. These are a well-trained group who perform reimbursable services. Advanced practitioners obtain medical histories, diagnose, and
prescribe. They perform procedures such as bone marrow biopsies and lumbar
punctures.8 Although many advanced practitioners function independently, it is
common to work with a collaborative physician.
Advanced practitioners play a key role in the diagnosis and management of
patients with hematologic disorders. Research shows that patient satisfaction,
patient safety, and quality indicators support the use of these providers across
references
1. Semmelweis I. (1983). The etiology,
concept, and prophylaxis of childbed
fever. Madison, WI: The University of
Wisconsin Press.
2. Best M, Neuhauser D. Ignaz Semmelweis
and the birth of infection control. Qual
Safe Health Care. 2004;13:233-4.
3. Rosenberg C. (1995). The care of strangers: The rise of America’s hospital system.
Baltimore, MD: Johns Hopkins University
Press.
4. Mariotto AB, Robin Yabroff K, Shao Y, et
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al. Projections of the cost of canc W"6&P