Advanced Registered Nurse Practitioners (ARNPs) may practice independently in Iowa. This practice is based on:

  • educational background
  • population focus
  • national certifying body standards and guidelines
    • Examples are American Nurses Credentialing Center and American Academy of Nurse Practitioners 

An ARNP may have a collaborative agreement with a physician(s), if warranted. This agreement is not required by the Iowa Board of Nursing.

The advanced nursing practice roles identified in Iowa are:

  • Certified Clinical Nurse Specialist
  • Certified Nurse Midwife
  • Certified Nurse Practitioner
  • Certified Registered Nurse Anesthetist

Standards for Treating Patients

Before treating a patient, ARNPs must:

  • Establish a patient-provider relationship
  • Perform and document or have access to the patient's health records, including:
    • Chief complaint
    • Health history
    • Focused assessment
    • Diagnosis
    • Plan of treatment
    • Maintain hospital privileges, if applicable

Education Requirements

To license as an Advanced Registered Nurse Practitioner, you must do one of the following:

  • Graduate from a Board approved Advanced Practice Master of Science in Nursing program
  • Complete a formal Advanced Practice education program
  • Advanced Practice Doctoral preparation is also an acceptable method for licensure.

For a list of Advanced Registered Nurse Practitioner Programs approved by the Iowa Board of Nursing, visit Nursing Education Programs.

Iowa Prescription Monitoring Program (PMP)

The Iowa Prescription Monitoring Program is a tool used to track the prescription of controlled substances. This includes Schedule II, III, and IV drugs. This program allows prescribers and pharmacists to determine the appropriate treatment of patients. The program assists practitioners in identifying potential diversion, misuse, or abuse of controlled substances. The Iowa Board of Pharmacy regulates this program.

To register for access to PMP and for more information, visit the Prescription Monitoring Program page.

Telehealth and Electronic Delivery of Care

Telehealth is the use of technology to deliver nursing care and conduct nursing practice. This includes audio, video, or data integration into nursing practice. The technology must be secure and comply with the Health Insurance Portability and Accountability Act.

If the patient is physically located in Iowa, nurses must have an active Iowa or multistate license.

The standard of care through telehealth is the same as an in-person setting.

Who Can I Provide Telehealth to?

If an established patient of an Iowa provider travels out of state, the nurse can answer the patient's questions via telehealth. The patient must be in transit and not residing in another state.

If the patient is out of state, the nurse can provide telehealth if the state is part of the Nurse Licensure Compact. If the patient is not located in a compact state, the nurse must be licensed in that state. The decision is based on the location of the patient at the time care is rendered.

For more information, visit the Nurse Licensure Compact page on telehealth.


ARNPs are subject to the same guidelines outlined on our Abandonment and Unethical Conduct page. Additionally, ARNPs must ensure patients have a provider if the ARNP discontinues care. Patients must also be properly notified when discontinuing care. Failing to do so may constitute abandonment.

Fluoroscopy Audit Process for ARNPs

Per Iowa Code, ARNPs may provide direct supervision in the use of fluoroscopic X-ray equipment. ARNPs who supervise the use of fluoroscopic x-ray equipment must have the appropriate education.

Fluoroscopy education must include:

  • radiation physics
  • radiobiology
  • radiological safety and management, including:
    • time
    • dose
    • distance
    • shielding
    • radiation effects
    • documentation verifying course completion

You must be in compliance with facility policies and procedures.

ARNPs supervising fluoroscopy during the three-year renewal cycle must take continuing education. For more information about fluoroscopy audits, visit our Continuing Education page.

ARNP Delegation

ARNPs are subject to the same guidelines outlined on our LPN/RN page. Additionally, ARNPs can only delegate appropriate tasks within a delegate's scope of practice.