Nurse Licensing in the United States
By MedXL Editorial Team · Updated 2026-08-26 · 6 min read
Nursing licensure in the United States is regulated at the state level, which means the license that lets you practice is issued by an individual state board of nursing, not by a national agency. The good news is that the core pathway is remarkably consistent from state to state: an approved education program, the NCLEX examination, and a board application. This guide walks through how the system fits together and where the state-by-state differences actually matter.
Every state, plus the District of Columbia and several US territories, has a board of nursing that licenses registered nurses (RNs) and licensed practical or vocational nurses (LPNs/LVNs). These boards set education standards, approve nursing programs, investigate complaints, and discipline licensees. They coordinate nationally through the National Council of State Boards of Nursing (NCSBN), which also develops and administers the NCLEX examinations.
Because each board is a separate legal authority, the details of applications, renewal cycles, continuing education, and background checks vary. Whenever you are unsure about a specific requirement, go directly to the website of the board in the state where you plan to practice. Board websites publish current application instructions, fee schedules, and processing information, and they are the only authoritative source for those details.
In this guide
- Who regulates nursing in the US
- The standard pathway to first licensure
- The Nurse Licensure Compact
- Licensure by endorsement
- Internationally educated nurses
- Advanced practice licensure
- Keeping your license in good standing
- Key takeaways