Family Nurse Practitioner (FNP)

Family nurse practitioners (FNPs) are advanced practice registered nurses (APRNs) who typically work in primary care settings and treat patients of all ages, from infants and teens to adults and seniors. An FNP’s focus is on health and disease prevention. 

While they can diagnose and prescribe medication, family nurse practitioners work in partnership with family physicians, physicians assistants, and nurses in their practices. They may also collaborate with social workers and other health care professionals depending on their place of employment.

FNPs earn a Master of Science degree in Nursing (MSN), often from a family nurse practitioner program, and are required to earn board certification and credentialing offered by the American Nurses Credentialing Center (ANCC). Passing a national certification exam and state licensing exams enables FNPs to practice family-centered primary care.

What Is a Family Nurse Practitioner? 

A family nurse practitioner has pursued a higher degree of education than a registered nurse (RN), including specialized classroom-based learning and hundreds of hours of clinical training in family practice. FNPs are trained to treat patients across the patient’s lifetime.

FNPs care for patients’ physical and mental health, teach wellness strategies such as nutrition and weight management and offer preventive care, including vaccination. They have the authority to diagnose and treat injuries, as well as conditions ranging from influenza to diabetes.

Roles and Responsibilities of a Family Nurse Practitioner

An FNP’s job may vary depending on their work environment, but typically includes:

  • Listening to and recording patient health histories.
  • Providing thorough physical exams.
  • Diagnosing and treating common acute and chronic health conditions.
  • Ordering and interpreting lab and other medical test results.
  • Developing treatment plans and prescribing medications and therapies, such as physical therapy.
  • Teaching basic health care and offering counseling that encourages healthy lifestyle behaviors.
  • Referring patients to other health professionals for more complex health and mental health problems (e.g., sending a patient with a fractured wrist or complex back problems to an orthopedist).

AANP offers an interactive “State Practice Environment Map” that provides NP licensure information for all 50 states, Washington, D.C., and U.S. territories. The following states allow NPs to enjoy full, independent practice:

  • Alaska
  • Arizona
  • Colorado
  • Connecticut
  • District of Columbia
  • Hawaii
  • Idaho
  • Iowa
  • Maine
  • Maryland
  • Minnesota
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Mexico
  • North Dakota
  • Oregon
  • Rhode Island
  • South Dakota
  • Vermont
  • Washington
  • Wyoming

FNP Education Requirements

The path to becoming a family nurse practitioner typically includes these steps:

Step 1: Complete a Bachelor of Science in Nursing (BSN) degree.

Step 2: Pass the NCLEX-RN exam and holding an RN license.

Step 3: Work for multiple years in a clinical setting.

Step 4: Complete a master's degree (MSN) from an accredited family nurse practitioner program, including either the Commission on Collegiate Nursing Education (CCNE), Accreditation Commission for Education in Nursing (ACEN), or the National League for Nursing Accrediting Commission (NLNAC).

Step 5: Pass FNP national certification exams through either the ANCC or the AANP.

Individuals may decide to earn an online MSN degree, either full-time or part-time. While earning an MSN, nurses take classes in evidence-based practice and organizational leadership and accrue anywhere from 500 to 700 clinical hours related to the FNP role. 

Some nurses may choose to take a different path toward becoming an FNP, which might involve earning an associate degree and enrolling in an RN to MSN program.

National FNP Certification

The American Nurses Credentialing Center (ANCC), a subsidiary of the American Nurses Association (ANA), offers the family nurse practitioner-board certified (FNP-BC) primary care certification. Eligible nurses — those with an RN, MSN or doctoral degree in nursing who have received special training at an accredited university or college specifically in family practice — can apply to take this computer-based certification exam year-round at a local test center. The exam is a 3.5-hour test that requires answering 175 questions (150 scored plus 25 pretest questions not scored). Retesting is available for those who do not pass. Test fees are $295 for ANA members and $395 for non-members.

Alternately, the American Academy of Nurse Practitioners (AANP) also offers a national certification in family practice; similar requirements apply. AANP offers “how-to” videos for nurses wishing to take their FNP certification exam. The AANPCB exam fee is $315 for first-time certification and $240 for AANP members.

Maintain the FNP Certification

To maintain national certification, FNPs should refer to the websites above. State licensing requirements may also vary by state. National certifications are typically valid for five years, but state licenses have varying durations. State nursing boards provide recertification requirement information.

FNP Professional Organizations

To stay up-to-date on trends and aware of networking opportunities, FNPs may wish to join professional organizations, many of which hold annual meetings and have local chapters.

Family Nurse Practitioner Salaries

In general, FNP salaries vary by location and the experience level a candidate brings to the position. A background in emergency patient care, case management, or geriatrics may increase a family nurse practitioner’s salary potential.

While the Bureau of Labor Statistics (BLS) does not break down average salaries by specialty, some data is available for nurse practitioner salaries. In 2018, NPs made an average of $110,030, according to the BLS.

The BLS also indicates that the following were the top-paying states for NPs in 2018:

Top-paying states for NPs in 2018
State Hourly mean wage Annual mean wage
California $64.32 $133,780
Alaska $59.08 $122,880
Massachusetts $59.01 $122,740
New Jersey $58.70 $122,100
New York $58.16 $120,970

Explore Online FNP programs

Online FNP programs may be a flexible and appealing option for busy working nurses who wish to pursue a specialty in family-focused health care while maintaining their full-time jobs. Some universities that offer online FNP programs include: