Protocol · NP · New Hampshire

Practice Protocol for Nurse Practitioners in New Hampshire

Nurse Practitioners practice independently in New Hampshire. A practice protocol is voluntary; here is what one covers and what the state does require.

Practice authorityIndependent practice
Written agreementNo agreement required
What New Hampshire calls itNo instrument required
Licensing boardNew Hampshire Board of Nursing and the New Hampshire Board of Pharmacy
Research date2026-09-03 · clauses 2026-09-03

RSA 326-B:11 grants APRNs 'plenary authority' to assess, diagnose, and prescribe within their scope, with no supervising-physician or collaborative-agreement requirement — NPs have practiced independently in NH since 1991, with no experience-based transition period, unlike most 'full practice' states.

What a voluntary Nurse Practitioner protocol covers in New Hampshire

New Hampshire requires no written protocol for nurse practitioners. These are the clauses a practice includes when it chooses to put one in writing. The New Hampshire Board of Nursing and the New Hampshire Board of Pharmacy governs nurse practitioners here.

  1. New Hampshire does not require the Nurse Practitioner to enter into a collaboration or supervision agreement with a physician. The Nurse Practitioner assesses, diagnoses, prescribes, and administers or dispenses drugs, including controlled substances, under the Nurse Practitioner's own license, consistent with N.H. Rev. Stat. Ann. § 326-B:11.

    Source: N.H. Rev. Stat. Ann. § 326-B:11

  2. If the Nurse Practitioner prescribes a Schedule II through IV controlled substance by telemedicine, the Nurse Practitioner shall ensure the patient receives a subsequent evaluation, capable of being conducted in person, by a prescriber at intervals appropriate to the patient and at least annually, as required by § 326-B:11.

  3. A voluntary protocol also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.

Statutes and rules these clauses cite

  1. N.H. Rev. Stat. Ann. § 326-B:11statute

    Authorizes Advanced Practice Registered Nurse independent diagnosis, prescribing, and dispensing under the nurse's own license.

What New Hampshire does require

The supervision and prescribing rules that apply to nurse practitioners regardless of any protocol.

Proximity

No proximity requirement

No physician relationship of any kind is required to practice full NP scope in NH (RSA 326-B:11).

Supervision ratio

Not codified — no cap on file

Chart review

Not codified

Meeting cadence

Not codified

Prescriptive authority

No agreement needed to prescribe · controlled substances permitted

Individual DEA registration and NH Prescription Drug Monitoring Program (PDMP) rules still apply on top of this statutory grant.

Written agreement

Not required

Unconditional — RSA 326-B:11 never requires a physician agreement for NP practice, regardless of experience.

Practice ownership (corporate practice of medicine)

Non-licensee ownership permitted — New Hampshire has no independent corporate-practice-of-medicine doctrine — an NP may be a direct corporate employee of a non-licensee-owned entity. An NP may alternatively organize as a Professional Corporation under RSA 294-A, in which case ownership is restricted to 'qualified persons' (licensed professionals, RSA 294-A:1, :8).

Secondary sources conflict on how far New Hampshire's permissive stance extends (see the state-level notes); entity structuring needs counsel.

Sources for the supervision rules (3)
How the relationship works day to day
Who has to be where, how often you meet, and what the physician costs: Nurse Practitioner in New Hampshire on collaborativeagreement.com.

About New Hampshire's rules

RSA 326-B:11 gives all APRN categories (NP/CRNA/CNM/CNS) plenary, independent practice authority with no supervising-physician or collaborative-agreement requirement and no experience-based transition period — unlike NC/VA. PA title changes to 'physician associate' effective 1/1/2027 (not yet live). NH has no independent corporate-practice-of-medicine doctrine; secondary sources disagree on how far that extends — verify before relying on any CPOM entry below.

Other clinicians in New Hampshire: see the state overview.