Neonatal nurse practitioners (NNPs) are advanced practice registered nurses (APRNs) who specialize in caring for preterm and sick infants. NNPs have challenging yet rewarding careers with high salaries. Read this guide to learn more about what it takes to enter this nurse practitioner specialty.
NNPs are specialized nurse practitioners who use advanced clinical skills to treat neonate patients. According to the American Association of Nurse Practitioners (AANP), NPs work “autonomously and in collaboration with healthcare professionals and other individuals, to provide a full range of primary, acute and specialty healthcare services.”
Neonatal nurse practitioners deliver care to preterm and sick infants with neonatologists in acute and nonacute settings. In some environments, they may also assist in delivering patients. NNPs care for patients suffering from conditions including:
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The average neonatal nurse practitioner salary in the US is $139,027 annually or $66 per hour, according to data from Salary.com in July 2024. They are the second highest-paid nurse practitioner specialty.
NNP incomes are also higher than nurse practitioners in general, which is $129,480 annually, as reported by the US Bureau of Labor Statistics (BLS).
Your location may be one of the biggest factors that impact your salary as an NNP. According to the BLS, the following states have the highest annual nurse practitioner salaries:
The BLS also reported the following highest-paying metropolitan cities for nurse practitioners:
NNPs perform several duties to care for sick and premature newborns. Some day-to-day neonatal nurse practitioner responsibilities include the following:
Additionally, neonatal nurse practitioners may provide post-discharge primary care services. They're also responsible for educating patients and families about the disease process and care plan.
Neonatal NPs can work in a variety of settings. Most commonly, they work in Neonatal Intensive Care Units, but they can also work in the following healthcare settings:
Most US hospitals have at least three levels of care for infants, with the most advanced hospitals having level four NICUs. These care levels group neonates and infants based on their needs. NNPs can work in any of these settings, though their daily tasks and duties will change depending on the environment.
Level one newborn care is for healthy, full-term infants. As such, the need for NNPs in level-one care is limited.
Premature or sick babies who need constant attention are generally assigned to level two care. Since these newborns have more risk factors, there's a higher need for NNPs at this care level.
This care level is reserved for the most seriously ill neonates. Patients assigned to level three care have critical health issues and need constant monitoring.
Hospitals must meet all level three capabilities and be able to care for infants born earlier than 32 weeks gestation weighing less than 1,500 grams. They must also be able to provide life support, perform advanced imaging, including MRI and echocardiography, and provide a full range of respiratory support.
In total, it takes between eight and twelve years to become a neonatal nurse practitioner. This timeline includes your undergraduate education, gaining relevant experience, grad school, and certification.
The following section is a step-by-step guide to becoming a neonatal nurse practitioner.
Before attending a nurse practitioner program, you must earn a Bachelor of Science in Nursing (BSN) degree and become a registered nurse (RN).
If you're already a practicing RN with an Associate Degree in Nursing (ADN), you must return to school and complete your BSN education. An RN to BSN program can take as little as one year, while traditional BSN degrees take three or four years to complete.
Additionally, you'll need to sit the National Council Licensure Examination for Registered Nurses (NCLEX-RN) to earn RN licensure. ADNs who complete an RN-to-BSN program will not need to retake the NCLEX.
Most neonatal nurse practitioner programs require at least two years of relevant experience for admission. You can gain this experience working as a neonatal RN or in another comparable, relevant role in a NICU setting.
Neonatal nurse practitioner programs culminate in a Master of Science in Nursing (MSN) or Doctor of Nursing Practice (DNP) degree. Earning an MSN takes one to two years, while DNP programs take three to four years to complete.
If you already have an MSN or DNP in another specialty, you can earn a post-graduate NNP certification instead of attending another graduate program.
After earning your graduate degree, you'll sit for the NNP board certification provided by the National Certification Corporation (NCC).
The Neonatal Nurse Practitioner (NNP-BC) Certification is an entry-level exam that tests your knowledge about caring for critically ill neonates. To sit for the exam, you must have completed an accredited MSN, DNP, or post-graduate NNP certificate program within the last eight years and hold current U.S. nursing licensure.
Remember, certification standards may vary by state. In addition to becoming board-certified through the NCC, you should contact your state's board of nursing to ensure you complete all certification requirements.
To help you choose the best route for becoming a neonatal nurse practitioner, we compiled a list of the top neonatal NP programs based on numerous factors, including graduation rate, cost, credit hours, and more. Check out our article on the best neonatal nurse practitioner programs for the full list of programs, as well as details like admission dates, tuition, and program length.
Like other NP programs, neonatal nurse practitioner degrees adhere to the nurse practitioner framework and core competencies established by the National Organization of Nurse Practitioner Faculties (NONPF). However, NNP education differs greatly from other specialties.
Since NNPs focus on a very specific, vulnerable population, they have quite a niche curriculum. While they take common nurse practitioner courses like advanced pharmacology and pathophysiology, they also attend classes like:
Though every neonatal nurse practitioner degree path is different, most have similar entry requirements, which generally include:
Neonatal nurse practitioners are granted the same rights as all other NPs throughout the country. Specializing doesn’t exclude them from any of the laws for this profession.
In 23 states, nurse practitioners have “full practice authority,” which means they do not have to work under the supervision of a doctor. Full practice states include Oregon, Maine, Alaska, Hawaii, Washington, and Iowa.
In states with reduced practice (e.g., Ohio, Pennsylvania, and Utah) and restricted practice (e.g., Texas, California, and Florida), NPs must have a medical doctor sign certain medical patient care decisions. NPs have prescriptive privileges in all 50 states and can administer controlled substances in 49 states.
This NP specialty is a stable career choice since, as long as people keep having babies, the world will need neonatal nurse practitioners. Additionally, high satisfaction rates and the allure of working independently generate interest in the career field, which may contribute to its growth.
While the BLS does not separate growth estimates by types of NPs, it does project that the entire nurse practitioner field will grow by 38% between 2022 and 2032. This is much faster than the national average of other healthcare-related professions, including registered nurses.
Check out these organizations for additional information and resources:
Still not sure which nurse practitioner path suits your career goals? Read our comprehensive NP career guides to learn more about different specialties:
