Missouri Nurse Practitioner Licensure Steps - 2024

Nurse Practitioner Licensure Requirements in Missouri

Follow below to learn how to become a nurse practitioner (NP) in Missouri.

Initial Registered Nurse (RN) Licensure

Already have your RN License?  Skip to the next section

The road to becoming a nurse practitioner (NP) in Missouri begins with attaining a registered nurse (RN) license. If you do not hold a single-state RN license to practice in Missouri or a multi-state RN license from one of the Nurse Licensure Compact (NLC) member states, you must apply for RN licensure from the Missouri Board of Nursing (MBN).

Holders of multi-state RN licenses from NLC states are only required to apply for a license in Missouri when they choose to change their primary state of residence to Missouri. You can apply for an RN license by Examination or by Endorsement.

RN by Examination

This is the ideal application route for people who have never been licensed to practice as RNs in any US state.

Applicants using this route should hold at least an associate degree in nursing to qualify for RN licensure. However, a bachelor’s degree is required if you intend to make the switch to an NP role in the future. Recent nursing school graduates are allowed to practice while supervised for up to 90 days immediately following graduation or until they pass the entry-level nursing test (whichever comes first).

The licensure application has to be signed and notarized and should include a personal email address for future communication. There is no application fee for anyone taking the exam for the first time. Applications are not accepted electronically and must be mailed to the following address:

Licensure requirements also include the following:

• Verification of citizenship or lawful presence
• A copy of your official transcript showing the degree awarded and graduation date. Electronic transcripts are to be sent to nursing@pr.mo.gov, as well as any other supporting documents.
• Submitting to a criminal background check (CBC) by registering at www.machs.mo.gov and using the four-digit registration code after registering, follow the instructions to complete the fingerprint background check. If you’re applying from out of state, follow these instructions. The CBC fee is determined by the vendor.

International students are required to have their credentials evaluated by the CGFNS or Josef Silny & Associates to show they meet the same standard of training required for Missouri RNs.

As an additional requirement, foreign students are required to pass one of the English proficiency tests. The tests are the IELTS, TOEIC, and TOEFL. International students are also required to complete the verification of their qualifications, identity, license, and residency on the Trueprofile website. You can find the application credentials required for foreign-trained applicants here.

All original documents provided by foreign-trained nurses must come with an English translation unless they are presented in English.

Exam registration is completed separately through the Pearson Vue website. All applicants are required to submit a correctly filled form and a $200 exam fee to take the National Council Licensure Examination for Registered Nurses (NCLEX-RN).

It’s recommended that you register for the NCLEX-RN between 1-3 months before your graduation date. You are to complete your licensure application before applying for the test so that the Board can notify the testing service of your eligibility. After this is done, you will receive an Authorization to Test (ATT). It’s important that you keep your name and contact information consistent throughout the application process.

If you need to retake the test, you can do so 45 days after your exam scores have been posted. You will have to pay the exam fee again and any other associated costs.

The results will be emailed within three business days of the test date. If there are any delays, you will receive a written notification.

RN by Endorsement

Nurses licensed as RNs in any US state or territory can apply via this route. They need to have passed the NCLEX-RN and fulfilled all Missouri licensure requirements.

The steps for Licensure by Endorsement include the following:

• Create an account on the Nursys platform. If you qualify for a temporary permit as you wait for MBN to process your application, a notification will be sent through the Nursys system.
• Complete, sign, and notarize the application, then send it in with the non-refundable fee of $105. The documents should be sent to the Missouri State Board of Nursing by mail at PO Box 656, Jefferson City, MO 65102-0656.
• Request the awarding institution sends an original copy of your transcript to the Board. This transcript must contain your graduation date and the degree awarded.
• Verification of licensure from the state where you hold a valid RN license is needed. You can find the information using the Nursys Licensure Verification for Endorsement function. If your Board does not report to Nursys, you must contact them concerning their verification process.
• Provide proof of citizenship or lawful presence in the US. Internationally trained applicants are required to submit English Proficiency test results, as covered in the previous section.
• Complete a CBC through an approved vendor, which can be found after registering at www.machs.mo.gov and entering the registration number 0001. Continue to follow the prompts on the website to finish the fingerprinting process. If you are outside Missouri, follow these steps for your fingerprinting. Note that fingerprinting and background checks require a fee as decided by the vendor.

Advanced Education Requirement

The Missouri Nurse Practice Act requires anyone licensed to serve as a nurse practitioner, or any other APRN, to have advanced education leading to the award of a graduate degree (master’s or higher).

The program must be taken at an institution regionally accredited by the Council for Higher Education Accreditation (CHEA). Appropriate national certifying bodies must have also accredited the program. Graduate programs must equip participants with knowledge and skills to practice as nurse practitioners serving specific population foci.

Your coursework must include advanced pathophysiology, pharmacology, and clinical management, among others. You must also have completed at least 1500 hours of clinical practice in your specialty. As all holders of an APRN license possess prescriptive authority for non-controlled substances, nurse practitioners who are required to handle controlled substances must apply for a permit. Academic requirements for applying include proof of one of the following:

• A letter from your APRN program showing in detail how preceptorship was integrated into your program
• 45 CE units of pharmacology or 3 hours of advanced pharmacology within the immediate past five years
• 1000 hours of clinical APRN practice
• 300 hours of APRN preceptorship in prescribing medications and therapeutic devices

National Certification

The task of determining the quality of your advanced practice education is left to appropriate national certifying agencies recognized by the Board. These agencies grant certification to professionals in specific specialty areas and for certain population foci based on successfully passing the examination.

The Missouri board of nursing has created a list of recognized agencies for the certification of NPs, which include:

• National Certification Corporation (NCC)
• Pediatric Nursing Certification Board (PNCB)
• American Academy of Nurse Practitioners (AANP)
• American Nurses Credentialing Center (ANCC)
• American Association of Critical-care Nurses (AACN)

Getting Licensed to Practice as a Nurse Practitioner in Missouri

Before applying for an APRN license in Missouri, you must familiarize yourself with the Nurse Practice Act. The first step is registering on the Nursys E-Notify platform through which you will receive your license. You should also opt for the automatic license renewal reminder.

The application fee is $150 and should be mailed with other supporting documentation. The fee can be paid with a money order or check payable to the Missouri State Board of Nursing.

Applicants for an APRN license are also required to submit proof of their national certification which may be a copy of their certification card or a statement of verification from the relevant national certifying agency. This proof must reflect the date of expiry of the certification.

Finally, you are required to complete an Authorization to Release Confidential Information and submit it with the other documents.

All correspondence from the Board will be made via email, so be sure to be consistent with the email address across all forms. Any questions should be sent to nursingpractice@pr.mo.gov.

APRNs in Missouri need a collaborative practice arrangement with a physician to provide healthcare services. The APRN license comes with prescriptive authority for legend drugs if outlined in the collaborative practice agreement.

Certification for prescriptive authority for controlled substances may be granted if you apply to the Board. You can view the application instructions here. Also, be sure to register with the Drug Enforcement Administration (DEA) as you are prescribing and dispensing controlled substances.