What is a North Carolina NP's scope of practice?

A North Carolina NP’s scope of practice is defined by education, national certification, and maintained competence, and includes a broad range of health services delivered with physician supervision and collaboration¹. To perform medical acts, an NP must have a collaborative practice agreement with a primary supervising physician, and that agreement helps delineate what the NP may prescribe, order, and perform at each practice site²³.

Within this scope, NPs may: promote and maintain health; prevent illness and disability; diagnose, treat, and manage acute and chronic conditions; provide guidance and counseling to individuals and families; prescribe, administer, and dispense therapeutic measures, tests, procedures, and drugs; consult and refer to other providers as appropriate; and evaluate health outcomes¹.

North Carolina law also allows NPs, when authorized within the collaborative arrangement, to complete medical certification for a death certificate upon supervising physician authorization⁴, and to conduct medical or physical examinations and sign related forms even when a statute otherwise requires a physician (without the physician being present)⁵. Nurses may carry out NP orders as if ordered by a physician⁶, and any NP prescription or order is deemed authorized by the supervising physician, who remains responsible for it⁷.