Neonatal Nurse Practitioner Career Overview
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What Does a Neonatal Nurse Practitioner Do?
NNPs typically work in hospital inpatient units like the neonatal intensive care unit (NICU), but some work in delivery rooms and clinics. These nursing professionals provide critical care to sick and premature infants and assist their families, which can be emotionally demanding but also rewarding. NNPs work closely with specialty physicians and often supervise registered nurses (RNs).
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Primary Responsibilities
- Delivering care to at-risk infants
- Supervising neonatal RNs and other nursing staff
- Educating and communicating with families
- Planning discharge for high-risk infants
Career Traits
- Empathy
- Advanced knowledge of nursing
- Stamina
- Communication
- Good judgment
Where Do Neonatal Nurse Practitioners Work?
According to data collected by the National Association of Neonatal Nurse Practitioners (NANNP), most NNP jobs are in hospitals or hospital systems. Almost 60% of NNP work primarily in a level III NICU and approximately 33% work in level IV units, which treat the most serious cases.
NNPs might find work in these common settings:
Level III NICULevel III NICU NNPs order tests and adjust treatments as needed, coordinate care with specialists such as respiratory therapists, and communicate with parents.
- Level IV NICU
At this level, NNP jobs may include tasks such as putting infants on life support, determining immediate analysis of tests and escalation of care, and collaborating with other neonatal specialists on treatment plans.
- Community/Home Care
NNPs work with families with severely ill newborns on their ongoing treatment, educating them on how to care for their child’s condition and when to seek further treatment. They may also act as primary care providers for infants with serious health problems.
Neonatal Nurse Practitioners vs. Neonatal Registered Nurses
While professionals in both roles provide necessary care to infants, the additional training and education that NNPs undergo enables them to provide a higher complexity of care than neonatal RNs and to take on leadership roles. Neonatal RNs hold at least two years of education and complete an RN certification exam. Neonatal NPs must earn a graduate degree and pass an advanced certification exam.
Neonatal Nurse Practitioner
Holds a master of science in nursing (MSN) or doctorate- Passed advanced certification exam
- Can diagnose, order treatment, and prescribe medications independently
- Earns higher salary (median annual NNP salary: $136,649 in 2025)
Neonatal Registered Nurse
- Holds an associate degree or bachelor of science in nursing (BSN)
- Passed certification exam
- Works under the supervision of an NNP or physician
- Earns lower neonatal nurse salary than NNP (median annual neonatal RN salary: $93,600)
How to Become a Neonatal Nurse Practitioner
- 1
Earn a BSN.
While nurses can be licensed as RNs with an associate degree in nursing, nurse practitioners need to earn a BSN or equivalent. - 2
Pass the NCLEX-RN to receive RN licensure.
Nurses need to pass the National Council Licensure Examination for RNs (NCLEX-RN) to earn their license. This national nursing exam mostly consists of adaptive multiple-choice questions. - 3
Gain nursing experience.
Most MSN-NP programs require or at least give admission preference to applicants with 1-3 years of full-time RN experience. Applicants must maintain an unrestricted RN license. - 4
Earn an MSN or a Doctor of Nursing Practice (DNP).
NNPs must complete an advanced degree. MSN programs usually take two years of full-time study, plus field work. DNP degrees can take longer to complete. - 5
Pass the NNP certification exam to become board certified.
This national examination, administered by the National Certification Corporation, assesses whether a graduate can safely provide care as an NNP.
How Much Do Neonatal Nurse Practitioners Make?
NNPs can gain access to high salaries and ample job opportunities. According to ZipRecruiter, NNPs earned an average annual salary of $136,649 in October 2025.
Salaries for NNPs vary significantly by geographic location and workplace setting. The annual salary for a nurse practitioner in California was $134,860, compared to an annual salary of $102,117 in both Florida. Nurse practitioners working in residential intellectual and developmental disability, mental health, and substance abuse facilities earned an annual salary of $163,000, while those working in outpatient care centers earned $143,600 per year.
In line with nurse practitioners as a whole, NNPs are in high demand. The U.S. Bureau of Labor Statistics projects a 40% job growth rate for nurse practitioners between 2024 and 2034, much higher than the national average for all occupations.
Resources for Neonatal Nurse Practitioners
Council of International Neonatal Nurses
COINN seeks to improve neonatal outcomes globally through promoting standards, advocacy, and sharing resources. While individuals are welcome to join, it works primarily as an international affiliation of organizations that seeks to strengthen neonatal nursing worldwide.
National Association of Neonatal Nurses
NANN issues publications, provides continuing education and other professional development, and offers fellowships. Membership is open to nursing students and RNs. NANN members who are NPs can join a special section for NNPs.
Association of Women’s Health, Obstetric and Neonatal Nurses
AWHONN’s mission focuses on nurse empowerment, research, and advocacy. It offers professional continuing education, such as fetal heart monitoring courses, and advocates for women’s and infant health. Membership is open to nurses and nonnurses, but only RNs can vote or hold office.
National Black Nurse Practitioner Association
Focused on advancing the careers of advanced practice registered nurses (APRNs), NBNPA fosters community and practices philanthropy. To facilitate their mission, NBNPA promotes networking and provides scholarships. Membership is open to APRNs; monthly meetings occur in the Houston, Texas area.
Frequently Asked Questions About Neonatal Nurses
It takes at least six years to become an NNP, including six years of education (BSN and MSN), plus the two years of RN experience typically required for admission to an MSN program.
Can NNPs prescribe medicine?
Like all nurse practitioners, NNPs can prescribe medications in most states, including controlled substances. In some states, nurse practitioners must work in collaboration with or under the supervision of a physician to prescribe controlled substances.
