Advanced Practice Registered Nurses

Advanced practice registered nurses (APRNs) are registered nurses who have received advanced training at a master’s/graduate or doctoral level. APRNs provide advanced clinical care to patients, including evaluating, diagnosing, ordering tests, providing treatment, and prescribing medications. APRNs are licensed by the Boards of Nursing in the state in which they practice. Additionally, they are certified by one of several national nursing organizations.

An APRN practices in one of four specialty areas, as a:

  • Certified registered nurse anesthetist (CRNA): provides patients’ anesthesia care
  • Certified nurse midwife (CNM): provides women’s health services, such as gynecological/obstetrician care, family planning, childbirth, and care of the newborn
  • Clinical nurse specialist (CNS): provides expert care in a particular focus area, such as a population (eg, geriatrics), type of problem (eg, wound care), setting (eg, ICU), type of care (eg, rehabilitation), or disease (eg, diabetes)
  • Certified nurse practitioner (CNP): practices at an advanced level and can provide care as an independent practitioner or work in a practice setting with other health care professionals. CNPs provide comprehensive care to patients in the fields of family medicine, internal medicine, pediatrics, geriatrics, and women’s health.

All APRNs must complete continuing education courses to maintain their specialty certifications. They must also maintain their licensure as a registered nurse in order to practice.

Physician Assistants

Physician assistants (PAs) are healthcare professionals who have received advanced training at a master’s level. PAs provide advanced clinical care to patients, including evaluating, diagnosing, ordering tests, providing treatment, and prescribing medications.

A PA’s education is modeled on the medical school curriculum and includes the same prerequisite coursework taken by physicians. During training, PAs gain experience in specialties including family medicine, internal medicine, obstetrics/gynecology, pediatrics, emergency medicine, psychiatry, and general surgery. PAs obtain a Master’s degree in PA studies.

PAs are nationally certified by the National Commission on Certification of Physician Assistants (NCCPA) and licensed to practice medicine by their state’s medical board. Like physicians, PAs must complete continuing medical education courses throughout their career. PAs recertify by exam every 10 years and must maintain their state licensure as a PA in order to practice.

Services provided by your advance practice caregivers

Whether you are seen by an APRN or a PA, advanced practice caregivers share many of the same patient care activities, including:

  • Obtaining patient histories and conducting physical exams
  • Developing a patient’s plan of care
  • Assessing and revising an existing plan of care
  • Ordering, interpreting, and following up on diagnostic tests and therapies
  • Prescribing medications
  • Providing patient, family, and community education
  • Performing diagnostic and preventive procedures

Last reviewed by a Cleveland Clinic medical professional on 05/19/2017.


  • National Council of State Boards of Nursing. APRNs in the US Accessed 5/1/2017.
  • American Academy of Physician Assistants. What is a PA? Accessed 5/1/2017.

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