NP · North Dakota
Supervision Agreement for Nurse Practitioners in North Dakota
No. Nurse Practitioners practice independently here. North Dakota does not require one.
No physician-collaboration requirement exists at all — the former rule provision on changing physician collaboration for prescriptive authority (NDAC § 54-05-03.1-12) was repealed effective October 1, 2011. Full authority attaches upon APRN licensure and separate prescriptive-authority approval.
What the supervision must look like
The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.
Proximity
Not codified — left to the agreement
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Initial prescriptive authority requires transcript evidence of advanced pharmacotherapy/assessment/pathophysiology coursework plus 30 contact hours of pharmacotherapy CE within the preceding 3 years (NDAC § 54-05-03.1-09); renewal requires 15 contact hours over 2 years (§ 54-05-03.1-11). Individual DEA registration required (§ 54-05-03.1-10(3)) — no collaboration agreement gates this. PDMP query required for new/unestablished patients, every 6 months during ongoing controlled-substance treatment, or on suspected diversion (§ 54-05-03.1-10(4)). May not prescribe controlled substances to oneself, a spouse, or a child (§ 54-05-03.1-10(7)).
Written agreement
Not required
Unconditional — no collaboration agreement of any kind is required for NP practice or prescribing in North Dakota.
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Professional corporation under N.D. Cent. Code ch. 10-31 (Professional Organizations Act) — shareholders must be licensed to render the same professional service as the corporation; no NP-specific ownership statute exists beyond this general framework.
Legal sources for these rules (3)
- N.D. Admin. Code ch. 54-05-03.1 — Advanced Practice Registered Nurse
- N.D. Admin. Code §§ 54-05-03.1-09 to -11 — Prescriptive authority (initial/renewal CE, DEA)
- N.D. Admin. Code § 54-05-03.1-12 (repealed eff. Oct. 1, 2011) — former physician-collaboration rule
What a supervising physician costs here
Typical monthly cost in North Dakota
$500 – $600
Estimate for one Nurse Practitioner. Standard-tier state.
About North Dakota's rules
H.B. 1175 (2019, eff. 2020) and a 2022 rule amendment repealed ND's old PA supervision-contract/ratio/countersignature model — PAs are now CONDITIONAL only below 4,000 practice hours or outside a qualifying facility. All four APRN roles (NP, CRNA, CNM, CNS) are FULL independent practice with no collaboration agreement of any kind.
Other clinicians in North Dakota: see the state overview.