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Highest Paying Nurse Practitioner Careers

NurseJournal Staff
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Updated November 29, 2022
    Nurse practitioners rank among the highest paid nurses. Find out which nurse practitioner specialities pay the most and how to get started in these fields.
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    Nurse practitioners (NPs) typically enjoy more job opportunities and higher salaries than registered nurses (RNs). According to the Bureau of Labor Statistics (BLS), RNs earn a median annual salary of $75,330, compared to $117,670 for NPs. Prospective NPs can choose from a variety of specialty areas, many of which offer six-figure salaries.

    RNs can enter the nursing field with an associate degree or a bachelor’s degree. However, NPs must earn a master of science in nursing (MSN) and specialty certifications due to their expanded responsibilities and scope of practice.

    Read on for more information about the highest-paid nurse practitioner specialties.

    Top 10 Highest Paying Nurse Practitioner Careers

    While the highest paid nurse practitioner specialties offer salaries above $100,000 a year, an NP’s earning potential depends on their employer, geographic location, and professional experience.

    Top 10 Highest Paying Nurse Practitioner Careers
    RankSpecialtyMedian Annual Salary Estimate
    1Neonatal nurse practitioner$128,057
    2Cardiology nurse practitioner$116,802
    3Orthopedic nurse practitioner$115,651
    4Oncology nurse practitioner$115,577
    5Family nurse practitioner$112,670
    6Psychiatric mental health nurse practitioner$109,664
    7Surgical nurse practitioner$109,597
    8Pediatric nurse practitioner$109,379
    9Women’s Health nurse practitioner$107,932
    10Endocrinology nurse practitioner$101,584
    Source: salary.com

    Salary potential is only one aspect to consider when choosing an NP specialty. The highest paying nurse practitioner specialties require advanced training, extensive clinical experience, and certification. The following section explores the educational requirements, employment prospects, duties, and work settings for each of these specialties.


    1. Neonatal NP ($128,057)

    These NPs care for newborns who may have been born prematurely or with complications. Neonatal NPs collaborate with physicians, order and interpret clinical tests, prescribe medication, and recommend therapeutic treatments. They must hold an MSN, an RN license, state authorization for advanced nursing practice, and the Certified Neonatal Nurse Practitioner credential.

    Job Outlook: The job growth rate for nurse anesthetists, nurse midwives, and NPs is projected to reach 45% from 2020-30. Despite this unprecedented growth, the nation’s current supply of neonatal NPs cannot meet the demand.

    According to the National Association of Neonatal Nurse Practitioners, hospitals are expanding their neonatal intensive care units, even as many current neonatal NPs reach retirement age. Thanks to the growing demand for this specialization, neonatal NPs are among the highest paid nurse practitioners, and individuals planning to enter this field can expect to find ample job opportunities in the coming years.

    Work Environment: Neonatal NPs work in hospital delivery rooms, neonatal units, and physicians’ offices.

    2. Cardiology NP ($116,801)

    Cardiology NPs work with physicians to treat diseases of the heart, blood vessels, and circulatory system. They care for adult patients with chronic diseases like hypertension and congenital heart disease, or children with congenital heart defects. They administer clinical tests, interpret the results, and educate patients and families.

    These nurses must earn an MSN degree and receive state authorization for advanced nursing practice. After completing 2,000 hours of clinical practice in cardiovascular nursing, prospective cardiology NPs can obtain the American Nurses Credentialing Center’s Cardiac Vascular Nursing certification or the Cardiovascular Nursing Level I certification from the American Board of Cardiovascular Medicine.

    Job Outlook: According to the Centers for Disease Control and Prevention (CDC), heart disease is the leading cause of death among adults in the United States. As a result, the demand for cardiology NPs should expand.

    Work Environment: These nurses practice in inpatient and outpatient settings, including emergency rooms, cardiac clinics, nursing care facilities, and private practices.

    3. Orthopedic NP ($115,651)

    Orthopedic NPs care for patients with muscular or skeletal conditions like arthritis, osteoporosis, scoliosis, and fractures. They provide basic care, help patients regain mobility after surgery, provide education, and coordinate patients’ care with physicians.

    Like other NPs, they must hold an MSN and advanced practice registered nurse (APRN) authorization from their state. Orthopedic NPs must complete at least 2,000 hours of APRN practice and obtain certification from the Orthopedic Nurses Certification Board.

    Job Outlook: While data for orthopedic NP job growth is unclear, they can expect growth similar to the 45% for all NPs. Orthopedic NPs also face an aging U.S. population that requires more specialists to treat and manage chronic conditions like arthritis, back pain, and joint issues.

    Work Environment: Orthopedic NPs work in doctors’ offices, bone and joint clinics, nursing and rehabilitation facilities, and inpatient and outpatient practices.

    4. Oncology NP ($115,577)

    Oncology NPs specialize in treating cancer patients. They assist surgeons during operations, collaborate with attending physicians to develop care plans, order tests and analyze results, and provide patients and their families with education. They must earn an MSN, obtain APRN licensure, and pass the Oncology Nursing Certification Corporation’s oncology nurse exam. Candidates eligible for the credential must complete at least two years of RN experience and 2,000 practice hours in oncology nursing.

    Job Outlook: A projected increase in cancer rates across all U.S. demographic groups should drive the demand for oncology NPs, with the National Cancer Institute expecting more than 1.9 million new cancer cases in 2021. Approximately 39% of adults will receive a cancer diagnosis at some point in their lives.

    Work Environment: Oncology NPs work in any setting that provides cancer treatment, including hospitals, clinics, doctors’ offices, and hospice care facilities.

    5. Family NP ($112,670)

    Family NPs perform many of the same duties as physicians. Depending on their state’s practice authority policies, family NPs may work independently or under a physician’s supervision. They provide adults, infants, and children with basic healthcare and checkups, diagnose and treat patients with acute and chronic conditions, prescribe medication, and order lab tests.

    Prospective family NPs must hold an active RN license and an MSN or doctoral degree from an accredited family NP program. Both the American Association of Nurse Practitioners and the American Nurses Credentialing Center offer family NP certifications.

    Job Outlook: Multiple factors have amplified the need for family NPs, as demand for primary and preventive care has grown in the midst of physician shortages. As a result, family clinics, hospitals, and community health facilities are hiring more staff, including family nurse practitioners, to assist with patient care.

    Work Environment: Family NPs practice in diverse work settings, including hospitals, clinics, outpatient facilities, schools, and community centers.

    6. Psychiatric Mental Health NP ($109,664)

    Psychiatric mental health NPs (PMHNPs) use their nursing, psychological, and neurobiological training to evaluate, diagnose, and treat individuals, families, groups, or communities. Depending on the state where they practice, they may work under a physician’s supervision. Many PMHNPs supervise RNs or nursing assistants.

    Prospective PMHNPs must complete an MSN or doctoral degree and study at least two psychotherapeutic treatment modalities. PMHNPs must also earn the Psychiatric-Mental Health Nurse Practitioner certification from the American Nurses Credentialing Center and obtain authorization to practice from their state’s nursing board.

    Job Outlook: Around 1 in 5 adults in the U.S. lives with mental illness, but less than 49% receive mental health services. Given this unmet need for behavioral and mental health treatment, employment prospects for PMHNPs are likely to grow. The National Center for Health Workforce Analysis projects that 6,690 PMHNPs will enter the workforce from 2016-30, representing an 18% job growth rate.

    Work Environment: Common work settings for PMHMPs include hospitals, mental health clinics, private psychiatric practices, and public health departments. Many work in schools, social service agencies, and correctional facilities.

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    7. Surgical NP ($109,597)

    Surgical nurse practitioners perform a variety of duties before, during, and after surgeries. They conduct preoperative assessments and assist surgeons and medical team members during operations. They also conduct postoperative assessments, assist patients during recovery, and complete admission and discharge paperwork.

    The Academy of Medical-Surgical Nurses administers the Certified Medical-Surgical Registered Nurse credential. After completing an MSN, surgical nurses may pursue specialty certifications in areas like intensive care, adult cardiac surgery, and plastic surgery.

    Job Outlook: Surgical nursing should remain an in-demand specialty, due in part to an aging population’s medical needs and the growing rate of chronic health conditions that require surgical interventions. The Association of Perioperative Nurses anticipates a surgical nursing workforce shortage as current nurses retire and nursing students demonstrate insufficient interest in this challenging specialty.

    Work Environment: These NPs work in hospitals, ambulatory surgical centers, Veterans’ Administration medical centers, private surgery specialty clinics, and physicians’ offices.

    8. Pediatric NP ($109,379)

    Pediatric nurse practitioners provide healthcare for sick and healthy infants, young children, and adolescents through 21 years old. Their job duties depend on their employment setting, but may include diagnosing and treating conditions, prescribing medications, ordering tests and x-rays, and educating patients and their families. They also assess growth and development benchmarks relative to patient age groups and administer required vaccinations.

    Pediatric NPs in all states must obtain certification through the Pediatric Nursing Certification Board to practice in primary care or acute care pediatric specialties. Eligible candidates for certification need an MSN, a valid RN license, and 500 clinical hours of supervised direct care.

    Job Outlook: Current demand for these NPs outpaces the supply, and this specialty ranks among the highest paying nurse practitioner jobs. According to the American Association of Nurse Practitioners, less than 4% of all NPs become certified in pediatric primary care and less than 1% in pediatric acute care. Job opportunities for pediatric NPs who hold full practice authority should expand in response to the anticipated physician shortage.

    Work Environment: Pediatric NPs find job opportunities in many healthcare settings, including hospitals, outpatient clinics, pediatrician specialty offices, school-based clinics, urgent care centers, and community health facilities.

    9. Women’s Health NP ($107,932)

    Women’s health NPs provide women of all ages with comprehensive healthcare services, including wellness exams, pregnancy testing, fertility assessments, screenings for sexually transmitted diseases, and menopause care.

    These NPs may practice independently or in collaboration with a doctor, depending on state regulations. Those seeking state authorization to practice must hold an MSN or higher, a valid RN license, and the Women’s Health Nurse Practitioner credential from the National Certification Corporation.

    Job Outlook: Currently, these specialists make up only 2.9% of all NPs. According to the Health Resources and Service Administration, the employment of women’s health NPs is projected to grow 8% by 2025 as more individuals recognize women’s health NPs as expert providers of women-focused primary and preventive care.

    Work Environment: Many clinical settings employ women’s health NPs. In addition to hospitals and family planning clinics, they work in women’s correctional facilities, community healthcare clinics, and private practices.

    10. Endocrinology NP ($101,584)

    This nursing specialty focuses on diseases and conditions of the glands and endocrine system, including diabetes, thyroid disorders, obesity, infertility, and hormonal issues. Endocrinology NPs treat patients from infancy through adulthood, diagnosing and treating hormone disorders and correcting hormone imbalances. They conduct ultrasounds, assist in biopsies, and perform screenings. They educate patients about medications, diet, exercise, and behavioral changes for a healthier lifestyle.

    After earning their RN license and graduate degree, these NPs must obtain state APRN licensure. Although there are no specific endocrinology certifications, most NPs interested in this specialty obtain the same credentials as family NPs.

    Job Outlook: As rates of endocrine disorders increase among all demographic groups, the need for these NPs is expanding. According to a recent CDC report, over 10% of the U.S. population has diabetes and over 34% of the adult population has prediabetes. An aging population seeking more preventive health services also fuels the growing demand.

    Work Environment: Endocrinology NPs typically work in hospitals, outpatient care centers, private practices, and clinics that treat specific hormone disorders.

    Top Paying States for Nurse Practitioners

    While NP salaries vary considerably throughout the country, the highest paying nurse practitioner jobs can be found on the East and West Coasts. New Jersey, New York, and Massachusetts offer the Northeast’s top salaries. NPs in the western U.S. make the most in California and Washington.

    StateHourly mean wageAnnual mean wage
    California$70.18$145,970
    New Jersey$62.93$130,890
    Washington$60.81$126,480
    New York$60.79$126,440
    Massachusetts$60.60$126,050
    Source: bls.gov

    Top Paying Industries for Nurse Practitioners

    NP salary levels also differ between workplaces. Aspiring NPs should consider a variety of employment settings. Common employers like hospitals and physicians’ offices may not necessarily offer the highest salaries.

    IndustryHourly mean wageAnnual mean wage
    Community Food and Housing, and Emergency and Other Relief Services$68.98$143,480
    Religious Organizations$63.32$131,710
    Residential Intellectual and Developmental Disability, Mental Health, and Substance Abuse Facilities$62.90$130,830
    Social Advocacy Organizations$61.52$127,970
    Outpatient Care Centers$59.54$123,850
    Source: bls.gov

    Nurse Practitioner Salary FAQs


    What type of NP gets paid the most?

    Neonatal NPs earn the most money and can expect continuing salary increases and a promising job outlook. Neonatal NPs who work in neonatal intensive care units or pursue relevant certifications can boost their earning potential. NPs who hold a doctorate in nursing can pursue lucrative leadership positions.

    Which nurse practitioner specialty is in highest demand?

    The demand for family NPs, gerontology NPs, and PMHNPs is high as more states grant NPs full practice authority to fill the need for primary and preventive care for all age groups. Family NPs should enjoy a particularly positive employment outlook. As the baby boomer population ages, the demand for NPs with gerontological certifications will also expand.

    The need for psychiatric mental health NPs has grown more pressing since the COVID-19 pandemic. According to the CDC, 40% of adults struggle with mental health and substance abuse issues, and a rising number of people between the ages of 18-24 experience depression or anxiety.

    How much do NPs make?

    ​​The most recent BLS wage estimates report the mean annual wage for all NPs as $114,510. However, NP salary levels fluctuate between employment settings and geographical locations. Earnings also vary according to the individual’s educational background, certifications, and professional experience. The lowest paid NPs make $82,960 a year, while the top 10% of earners earn $156,160.

    What pays more, nurse practitioner or RN?

    NPs usually earn more than RNs due to their advanced training, clinical experience, and certifications. The median annual salary for RNs is $36,000 below the median NP salary. While the projected job growth rate for all nursing positions ranks higher than the national average for all occupations, NP positions will outpace most professions in healthcare and other sectors. The BLS projects a 45% growth rate for NP positions from 2020-30, compared to 9% for RN jobs in the same period.

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