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Nurse Practitioner Specialities: Explore Different Types of NPs

Gayle Morris, BSN, MSN
Updated March 28, 2024
An advanced nursing degree can offer flexibility and higher pay. These eight types of nurse practitioner specialties afford options in primary and acute care.
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Nurse Practitioner Specialties

Are you interested in an advanced degree in nursing that can allow you greater flexibility and higher compensation? Consider becoming a nurse practitioner. A master of science in nursing (MSN) degree can unlock many career opportunities in primary care, specialties, and subspecialties.

Nurse practitioners specialties include the care of specific groups, such as women, children, adults, and older adults. NPs can choose to specialize even further. For example, they may treat children with endocrine disorders or adults with cardiovascular diseases.

This guide will cover factors to consider when choosing a nurse practitioner specialty. This includes where nurse practitioners work, their average annual salaries, and certifications.

Types of Nurse Practitioners

Nurse practitioners receive advanced clinical training and education in a population focus. This means that all NPs are certified in a specialty. National organizations, like the American Association of Nurse Practitioners (AANP) and the American Nurses Credentialing Center (ANCC), offer certifications. Many specialties are recognized by nursing state boards.

NPs can choose certifications in several specialties or a subspecialty. For example, a certified family nurse practitioner may get an adult psychiatric mental health certification. Conversely, a pediatric nurse practitioner can be certified in rehabilitation, school nursing, or research.

According to the AANP, 88.9% of nurse practitioners choose a primary care specialty and 70.2% deliver primary care in their practice. Of all certified NPs, 69.7% are family nurse practitioners and 10.8% are certified adult nurse practitioners. The remaining 10 nurse practitioner specialties make up 19.5% of certified NPs. These include gerontology, adult, pediatric, and women’s health.

Family Nurse Practitioner (FNP)

Family nurse practitioners provide primary care across the lifespan. They are responsible for developing and implementing a plan of care to treat chronic conditions. They also provide preventive guidance and administer prenatal care. FNPs perform examinations and assessments, diagnose disease, order lab and imaging tests, and prescribe medications when necessary.

Their diverse skill set makes them a vital resource to communities where they serve as primary care providers. FNPs are highly sought after for their ability to care for patients of all age groups. FNPs may provide care in clinics, office settings, skilled nursing facilities, hospitals, acute or urgent care centers, emergency departments, correctional facilities, and hospice centers.

To be eligible for an FNP program, candidates need a BSN, RN license, and possess experience in an associated field such as pediatrics, EDs, cardiology, or medical surgery.

  • Specialty Board Certification Exam:AANP or ANCC
  • Average Annual Salary: $107,000 AANP 2019
  • Percentage of NPs With this Certification: 69.7%

Adult-Gerontology Primary Care Nurse Practitioner (AGPCNP-BC)

This is the second most popular nurse practitioner certification. Senior adults have changing healthcare needs as they age. Adult-gerontology nurse practitioners are educated to address the needs of younger and older adults. The need for these practitioners continues to expand as the baby boomer generation moves into retirement.

The demand for healthcare providers who work with the elderly continues to grow. Adult-gerontology primary care NPs start their career as an RN. They are certified after completing an MSN program with a focus on adult and eldercare. They can work in a variety of healthcare settings including clinics, family practice offices, long-term care facilities, hospice care centers, rehabilitation centers, and home care.

  • Specialty Board Certification Exam:ANCC
  • Average Annual Salary: $107,000 AANP 2019
  • Percentage of NPs With this Certification: 7%

Psychiatric-Mental Health Nurse Practitioner (PMHNP-BC)

Psychiatric-mental health nurse practitioners earn competitive salaries. It is the fourth most popular type of nurse practitioner. Yet, this group accounts for only 4.7% of all certified NPs. These practitioners have a high level of autonomy. They work in a field where patients continue to fight through social stigmas that surround mental health.

Candidates must first be an RN with one to two years of experience before applying to a psychiatric-mental health MSN program. After completing coursework and faculty-supervised clinical hours, they take the certification examination. Psychiatric-mental health NPs are qualified to work in correctional facilities, private psychiatric practices and clinics, mental health departments, hospitals, and education systems.

  • Specialty Board Certification Exam:ANCC
  • Average Annual Salary: $119,000 AANP 2019
  • Percentage of NPs With this Certification: 4.7%
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Adult-Gerontology Acute Care Nurse Practitioner Certification (AGACNP-BC)

Nurse practitioners who prefer to work with adults and the elderly may also be certified in acute care practice. Acute care practitioners focus on sudden illness or injury. They also treat the exacerbation of chronic disease conditions. Their scope of practice differs from primary care practitioners. Instead of managing health over a lifetime, they care only for patients with acute conditions.

Adult-gerontology acute care practitioners collect and evaluate information based on several factors. These include a patient’s history, symptoms, physical findings, and diagnostic tests. Vigilant assessment and evaluation of dynamic health conditions and reactions are required to adapt treatment plans to fit the needs of the patient.

Adult-gerontology acute care nurse practitioners can work in a variety of healthcare settings. This can include hospitals, emergency departments, and urgent care facilities. Their preparation includes an accredited MSN program, 500 or more clinical hours, and certification examination.

  • Specialty Board Certification Exam:ANCC
  • Average Annual Salary: $112,000 AANP 2019
  • Percentage of NPs With this Certification: 2.9%

Women’s Health Nurse Practitioner (WHNP-BC)

Women’s health nurse practitioners provide primary or acute care to adolescents and women. These healthcare practitioners have specialized education in women’s health issues. Yet, they can also provide primary care.

A women’s health practitioner can perform procedures related to women’s health, including prescribing birth control and helping women adjust to menopause. While WHNPs can provide pre/postnatal care, they cannot deliver babies.

WHNPs need a strong foundation in psychology as they often assess issues directly related to sexual abuse, postpartum complications, and depression. The population focus is versatile, which allows these practitioners to practice in private practices, college health clinics, Planned Parenthood, prenatal clinics, women’s correctional facilities, and occupational health settings.

  • Specialty Board Certification Exam:NCC
  • Average Annual Salary: $105,000 AANP 2019
  • Percentage of NPs With this Certification: 2.9%

Neonatal Nurse Practitioner (NNP-BC)

Neonatal nurse practitioners nearly always meet their patient’s families at one of the most stressful times in life. They are experts at neonatal care, when preterm or full-term infants may be spending weeks or months in the intensive care unit.

These healthcare practitioners can work independently in the NICU and in collaboration with a neonatologist or other specialists. They may also be found in labor and delivery, emergency rooms, and specialty clinics.

Neonatal nurse practitioners begin their career as an RN with at least two years of experience, usually in the neonatal intensive care unit. They apply, enroll, and complete an accredited NNP MSN program. The job is emotionally demanding, yet rewarding. It requires practitioners to have strong communication skills, good judgment, and deep empathy.

  • Specialty Board Certification Exam:NCC
  • Average Annual Salary: $122,500 AANP 2019
  • Percentage of NPs With this Certification: 1%

Primary Care Certified Pediatric Nurse Practitioner (CPNP-PC)

Primary care pediatric nurse practitioners make up 3.2% of all certified nurse practitioners. They play a unique role in the lives of pediatric patients from birth through adolescence. Their scope of knowledge must include normal and abnormal growth and development. They are treating patients at a time when they are constantly growing and changing.

Primary care pediatric nurse practitioners assess their patients, diagnose acute and chronic conditions, order and interpret diagnostic tests, and prescribe treatments. They also educate children and their families about activity level, eating and nutrition choices, vaccine schedules, and positive lifestyle choices.

A CPNP’s interaction with children and adults requires critical thinking and reasoning, a strong foundation in normal and abnormal psychology, and effective communication skills. Primary care pediatric NPs may work in the education system, clinics, private offices, and long-term care centers.

  • Specialty Board Certification Exam:PNCB
  • Average Annual Salary: $108,500 AANP 2019
  • Percentage of NPs With this Certification: 3.2%

Acute Care Certified Pediatric Nurse Practitioner (CPNP-AC)

According to AANP, less than 1% of all certified nurse practitioners are CPNPs. These unique APRNs treat acute injuries, illnesses, or an exacerbation of chronic diseases. Acute care PNPs need empathy, patience, and a deep-seated passion for caring for children. At the same time, they must have strong communication skills to manage relationships with the child’s caregivers.

CPNPs need at least 1-2 years of ICU, PACU, or ED experience caring for pediatric patients. They must apply, enroll, and graduate from an accredited acute care MSN program with a focus on pediatrics. After completing the curriculum and necessary clinical hours, they may sit for the certification examination. They may work in hospitals, intensive care units, emergency departments, and urgent care settings.

  • Specialty Board Certification Exam:PNCB
  • Average Annual Salary: $112,000 AANP 2019
  • Percentage of NPs With this Certification: 0.7%

Other Nurse Practitioner Subspecialties

Other NP specializations are less common, but just as essential to healthcare. In these cases, nurses often are certified in more than one specialty. For example, certified cardiovascular nurse practitioners may also hold a primary certification as a family or adult nurse practitioner. A certified emergency NP may have a primary certification as an adult acute care NP. Other subspecialties include:

  • Aesthetic
  • Orthopedics
  • Dermatology
  • Forensics
  • Gastroenterology
  • Hospice
  • Nephrology
  • Oncology
  • Pain Management

Nurse Practitioner Certification Boards

Certification programs validate competency and professional expertise. There is no one national organization responsible for all certifications for nurse practitioners. The following is a list of certification boards.

  • The American Academy of Nurse Practitioners Certification Board (AANP)

    This nonprofit board administers and processes certifications for family nurse practitioners, adult-gerontology primary care, and emergency specialty certification. The certification programs are accredited by the Accreditation Board of Specialty Nursing Certification and the National Commission for Certifying Agencies.
  • The American Nurses Credentialing Center (ANCC)

    The organization offers several core certifications, including family, adult-gerontology primary care, adult-gerontology acute care, and psychiatric-mental health. Additionally, they offer specialty certifications in pain management, case management, executive certification, cardiovascular, and informatics.
  • The American Association of Critical Care Nurses (AACN)

    The organization focuses on two certifications for acute care and critical care nurse practitioners – acute care adult-gerontology and acute care adult nurse practitioners. They also offer a certification for clinical nurse specialists. AACN provides volume discounts for employers, certification verification, and resources to prepare nurses for the certification examinations.
  • The Pediatric Nursing Certification Board (PNCB)

    The board offers four certifications in pediatrics, three of which are for APRNs to validate knowledge and critical thinking skills. APRN certifications include primary care pediatric NP, acute care pediatric NP, and primary care pediatric mental health specialist. The exams are endorsed by the American Academy of Pediatrics and the National Association of Pediatric Nurse Practitioners (NAPNAP).
  • National Certification Corporation (NCC)

    The organization administers certifications in two core NP specialties — women’s health and neonatology. They also offer specialty certifications in other areas, including antepartum, low-risk neonatal intensive care, electronic fetal monitoring, and extremely low birth weight neonates.

Frequently Asked Questions About Nurse Practitioner Specializations

question-mark-circleWhat are the highest-paid nurse practitioner specializations?

The highest reported annual base salary from the 2019 AANP survey was $125,000 for an adult psychiatric-mental health practitioner. This was followed closely by four other NP specializations, all making annual salaries over $120,000. They include pediatric primary care mental health practitioners, neonatal NPs, acute care NPs, and psychiatric mental health NPs.

question-mark-circleHow hard are the nurse practitioner certification exams?

How hard the nurse practitioner certification examination will be depends on several factors, including test preparation, test anxiety, and study time. Generally speaking, you may get an indication of the difficulty of the exam based on the pass rate statistics. The pass rate from the AANP in 2020 was 85% for MSN-prepared FNPs and 90% for DNP-prepared FNPs.

Adult-gerontology primary care and emergency NP specialty exams had pass rates of 86% and 89% respectively. The overall pass rate for ANCC certifications in 2020 was 83.6% and the NCC exam results in 2020 ranged from 80% to 92%. The neonatal intensive care subspecialty examination appeared to be the most difficult with a pass rate of 74%.

question-mark-circleWhich nurse practitioner specialty is in highest demand?

Primary care and mental health make up the top healthcare shortage areas, according to HRSA data. FNPs are roughly 70% of all certified NPs and work in a variety of healthcare settings. Yet, the highest-paid NPs are in psychiatric and mental health. NPs are in greatest demand in inpatient and outpatient hospital settings.

question-mark-circleCan nurse practitioners change specialties?

Nurse practitioners can switch specialties at any time during their careers. While it’s not difficult, it may require additional education, on-the-job training, and certification.

To find out exactly what is required to meet the standards in your facility and state, contact the HR department at your healthcare facility and the state board of nursing. You may need to complete a post-master’s certificate program to complete the switch.

Page last reviewed: April 4, 2022

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