Protocol · NP · North Dakota
Practice Protocol for Nurse Practitioners in North Dakota
Nurse Practitioners practice independently in North Dakota. A practice protocol is voluntary; here is what one covers and what the state does require.
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— the former rule provision on changing physician collaboration for prescriptive authority (NDAC § 54-05-03.1-12) was repealed effective October 1, 2011.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 a voluntary Nurse Practitioner protocol covers in North Dakota
North Dakota requires no written protocol for nurse practitioners. These are the clauses a practice includes when it chooses to put one in writing. The North Dakota Board of Nursing and the North Dakota State Board of Pharmacy governs nurse practitioners here.
North Dakota does not require the Nurse Practitioner to enter into a collaboration or supervision agreement with a physician. The Nurse Practitioner practices and prescribes independently under the Nurse Practitioner's own license, consistent with N.D.C.C. ch. 43-12.1.
Source: N.D.C.C. ch. 43-12.1
This Agreement's terms regarding the Nurse Practitioner accordingly serve to define the working relationship, referral pathways, and any Medical Director oversight between the Parties, and are not themselves required by North Dakota law as a condition of the Nurse Practitioner's authority to practice.
- A voluntary protocol also carries 1 scope, 1 education and 1 registration clauses, authored in the document itself.
Statutes and rules these clauses cite
- N.D.C.C. ch. 43-12.1statute
North Dakota Nurse Practice Act, governing Nurse Practitioner and Registered Nurse licensure and practice.
What North Dakota does require
The supervision and prescribing rules that apply to nurse practitioners regardless of any protocol.
Proximity
Not codified
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
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.
Sources for the supervision 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
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.