Ep #138: NPI, DEA, and Credentials: What Happens After Your NP Board Exam?

Welcome to the Real Deal Nurse Practitioner Club, the podcast for nurses who are ready to pass their boards and thrive in their careers as real deal nurse practitioners. I’m Anna and I’m the Director of Nursing Content at Blueprint Test Prep. Whether you’re deep in exam prep or stepping into practice, I’ve got you. It is time to become the confident, knowledgeable NP that you’re meant to be. Let’s dive in.

Hey, hey everyone. Welcome back to the Real Deal Nurse Practitioner Club podcast. I am really excited about this episode today because I’m going to talk about what happens after you pass your board exam. We get this question over and over and over again in both our student and our new NP Facebook communities. Right, you go to school for a few years, you complete hundreds and hundreds of clinical hours, and you prepare for this big exam to let you practice as a nurse practitioner. But then what?

We have received some excellent suggestions and questions, and so I just wanna walk through these common questions for new NPs after passing boards. We’re gonna cover things like, how do you get an NPI number? Is your license the same as your certification? Even how do I write my name and my initials now? So really excited, let’s go ahead and jump in.

Let’s start with the next step after you pass boards, other than to celebrate of course. Remember the board exam is for certification, so that means you have demonstrated the knowledge to be certified in a particular specialty of NP practice. And then licensure is different. That’s your ability to practice that specialty in a particular state.

So after you pass boards and you’re certified, you have the certification, the next thing you need to do is apply for your license in your state. So to apply for licensure as an NP, you’re gonna need to show proof of passing your certification exam, and this can actually take a few weeks. You need to receive that passing report from ANCC or AANP and they will submit that to the state board.

And be sure to review the steps for your state before applying and make sure you have all the information you need. Make sure you’ve checked the fees for being licensed as they do vary state to state. Your state will also need to verify your education, so be in touch with your program director and faculty and make sure any necessary information has been sent. And once you apply, just know that it can take several weeks for your information to be verified before your license is issued. Now some states do let you get a jump start on this and you can actually start this application before your certification, but remember that certifying board is still going to have to report you passing before you will officially be licensed.

Now I’d say the next question we get a lot is when can or when should I start looking for a job? And the answer here is really whenever you feel ready. Some people choose to wait until they have passed their board exam so that the stress of that preparation is behind them. But we also have learners who have started to apply for jobs during their last semester of their NP program, and that’s also okay.

Just make sure that you are upfront about your graduation date and your general timeline for taking your board exam. But if the potential employer is excited about you and your experience, and they think you’re gonna be a good fit for the practice, they may be willing to wait for you until you graduate. And I see that a lot with people landing jobs at sites they’re doing clinical rotations at. Do not hesitate to use your network to your advantage.

Also, I want to take a minute and remind all of you about our Job Hunt course from SMNP Reviews. So if you go on our website, you look under that post certification tab, you can see all of this information, but you can just receive some help with building your resume, writing cover letters, we go over common interview questions, we talk about understanding and negotiating your NP contract from an employer and so much more, and we even have a mock interview in there. And so it’s just a really great opportunity to feel prepared and to feel confident in your NP job search.

Now, another common question I get is, how do I write the initials after my name? In nursing, you know we love a good like alphabet soup after our names. So let’s go over how to write your NP credentials after your name, after you’ve passed your boards, and you’ve been licensed. The general order is your degree, your license, and then your certification. So this means you’ll put the highest degree you’ve earned, followed by your licensing initials and include any state specific information here. And then lastly, you’d list your certification.

So like I said highest degree is always listed so that could be your MSN or you might write DNP for example. For licensure you need to check what your license says. For example, some states use Advanced Practice Registered Nurse, APRN, while some use Certified Registered Nurse Practitioner, so CRNP. And since your NP license supersedes your RN license, you don’t need to include RN in your initials anymore.

Then you can list your certification. So that’s whichever board certification exam you take. So the certifying body will provide you with information about what initials to use. So for example, a family nurse practitioner who’s certified through ANCC would use the initials FNP-BC.

The next related question is, do you have to list all of your initials or credentials every time you sign your name for an order in your clinical practice. You totally could. However, it’s more practical to just write your state licensing initials. So for me, when signing orders, papers, or other legal documents for the medical record, I can just write Anna Miller APRN. And in that capacity, my state licensure is most important and is what allows me to practice, right?

Okay, let’s move on now. Let’s talk about what the NPI number is and how you get one. Once you are certified and licensed, even before you have a job, you should apply for an NPI number. And so that brings me to that next frequently asked question, what is an NPI number? How do I get one?

So NPI stands for National Provider Identifier. It is a unique 10-digit number that healthcare and insurance companies use when billing for transactions. Now, you can apply for an individual NPI number, which does not require employer information, but you can always add that later on. The NPI number is one of those first crucial steps in being able to get credentialed with different insurances and organizations once you start working. Basically, if you plan on prescribing medications and billing for services, you need an NPI number.

So, how do you get one? You can either just Google for the link, or you’ll go to nppes.cms.hhs.gov to apply. You will follow the steps to create an account, and there are tons of helpful tools to walk you through the process. And this application is free.

Once you complete your application it can take anywhere from 10 to 30 days to receive your NPI number and it really just depends on how fast your application can be reviewed and your information verified. Now, a lot of people do wait until they have secured employment because it will ask for an address and this is public information. So a lot of people wanna put their employer or their clinic’s address instead of your personal address on there.

Next up, let’s talk about a DEA number. So DEA stands for Drug Enforcement Administration, which oversees the distribution of controlled pharmaceutical substances, as well as illicit illegal substances in the United States. So as a provider, if you will be prescribing any controlled substances, you will need a DEA number.

As a nurse practitioner, you’ll be able to prescribe schedule two through five substances, although that could be more restricted depending on your state or your prescribing agreement with your supervising physician or your employer. So are all medications a controlled substance? No, right? A controlled substance means that the medication has the potential for abuse or addiction. Non-controlled substances include medications like antibiotics, cholesterol meds, antihypertensives, and most diabetes medications.

In terms of the schedule, schedule five medications have the lowest potential for abuse or addiction, and that’s drugs like ones that contain codeine. And then the abuse and the addiction potential increases up to schedule one and two medications. Schedule one medications have the highest potential for abuse and addiction and really they have no accepted medical use and they include things like LSD and heroin. These medications are only prescribed typically for medical research and they require very, very, very strict regulations.

Now if you will be prescribing any controlled substances, like I said, you’re going to need to apply for this DEA number. You will need to include information about your employer, so don’t apply for this DEA number until you’ve signed that contract for an NP position. For this you will go to DEADiversion.usdoj.gov and you’re going to follow the instructions for the application and be prepared to have the following information ready.

You’re gonna need to have your professional qualifications and credentials, the specific schedule of controlled substances you intend to prescribe, and your NP license state and your license number. And very important here, it’s important to note that while the NPI number is free, a DEA number is not.

As of 2023, for both initial applications and renewals, the cost was $888 every three years. Now, you might be able to include reimbursement in your job contract. So be sure to ask if that cost is included for you. Now, with those NPI and DEA numbers, I mentioned that’s one of the first steps of credentialing.

So what is credentialing? Once you accept a job, you will undergo the credentialing process. And essentially that’s just how your employer or your healthcare organization and insurance providers make sure you have all the necessary credentials to practice as a provider. This means verifying your education, your certification, and your licensing. All of those are going to be reviewed. You’ll also be asked to provide proof of malpractice insurance or be added to the organization’s policy.

Even though you have had to provide proof already of education to take your certification exam, proof of education and certification to obtain your licensure, your employer will still likely require copies of your diploma and your transcripts to keep on file. To be added as an approved provider for both public and private insurances, you’ll also be likely asked to provide proof of education, certification, licensure, malpractice insurance, NPI number, and possibly that DEA number as well.

And I know this whole thing sounds somewhat repetitive, but think of credentialing like this big vetting process. When you sign a contract for an NP job, you’ll likely notice that the start date is two to three months away. And that gives your employer time to review all of these qualifications and get you improved by insurance companies so that once you start seeing patients, your charting and your billing will be good to go for reimbursement. So keep that in mind, credentialing can take a long time. Once you find a job, it will likely take at least two to three months before you are actually credentialed.

All right, what else do we need to know? You’ve passed your boards, you’ve got your license, you’ve applied for your NPI and your DEA, you’ve completed all of your credentialing requirements, and you’re now practicing. So what do you need to keep your licenses and your certification? This is where those continuing education credits come in. They are a requirement for maintaining certification and licensure, including that DEA license.

The main reason for continuing education is that it’s a way for NPs to stay up to date on all of the changes that happen in healthcare, right? We know that evidence-based practice and clinical guidelines are always changing. Now, continuing education requirements vary greatly from state to state, both in terms of the number of hours and specific topics needed. So you will have to check with your state’s board of nursing for the requirements of your RN and NP licenses. And yes, you do need to maintain your license as an RN while practicing as an NP, so make sure you understand the requirements for both. And you’ll also need to check the requirements for your board certification and any additional certifications you hold, including requirements for those pharmacology CE credits.

Ultimately, the best advice I have here is just to stay organized and stay on top of it. Keep dedicated files, keep copies of all of your CE certificates so that you can upload them when needed, and you can make any renewal a very smooth process.

Okay, I think that’s enough for this episode. I hope that this helps you just feel more prepared about what to expect after passing boards. And I am so excited that if you’re listening to this, it means you’re getting closer to becoming that real deal NP. So thanks for tuning in. Be sure to follow us wherever you listen to podcasts. And you can also find us on YouTube and Facebook. I’ll see you next time.

 Thanks for listening to another episode of the Real Deal Nurse Practitioner Club. If you want more information about the different types of support that we offer to students and new nurse practitioners, you can visit npreviews, with an S, dot com. We’ll see you next week.