Healthcare

Nurse Practitioner Salary 2026 — Take-Home Pay by State

Nurse Practitioners (NPs) are advanced practice registered nurses with master's (MSN) or doctorate (DNP) degree, board certification through ANCC or AANP, and prescriptive authority. Six population foci: Family (FNP), Adult-Gerontology Primary or Acute Care (AGNP-AC/PC), Pediatric (PNP), Psychiatric-Mental Health (PMHNP), Women's Health (WHNP), and Neonatal (NNP). BLS projects 38% growth 2022-2032. NP scope of practice varies by state: Full Practice Authority (24 states + DC), Reduced Practice (16 states), Restricted (10 states). PMHNP highest-paid specialty post-2020 mental health crisis ($145K-$220K). Aesthetic NP (cash-pay Botox/fillers/med spa) uniquely lucrative 1099 path. CRNA path ($240K-$320K) and CNM path ($120K-$155K) are sister APRN tracks.

National Median

$129,480

Best State (Net)

$110,110

Washington

Take-Home TX

$99,502

No state tax

Job Growth

BLS projects 38%

Key Facts — Nurse Practitioner 2026

BLS median: $129,480 for nurse practitioners (BLS May 2023 OES); PMHNP $145K-$220K; aesthetic NP cash-pay $200K-$400K+ owner draw

Full Practice Authority (24 states + DC) allows NP independent practice without physician supervision; Reduced/Restricted states require collaboration agreement

DNP (Doctor of Nursing Practice) increasingly preferred over MSN — AANP/AACN movement to all-DNP entry by 2025-2030

PMHNP highest-paid specialty post-2020 mental health crisis; telepsychiatry 1099 at $150-$200/hr

Aesthetic NP (Botox / fillers / med spa) cash-pay 1099 + S-corp election + Section 199A QBI — uniquely lucrative tax structure

Solo 401(k) for 1099 NP up to $70K/year (2026 limit); S-corp election at $80K+ net SE saves $4K-$8K/year SE tax

PSLF (Public Service Loan Forgiveness) for hospital-employed NPs — 10 year qualifying-payment + 501(c)(3) employer = $0 tax-free debt forgiveness

Schedule II controlled substance prescriptive authority varies by state (FPA states fuller authority; some RPA states limited)

Salary by Experience Level

New Grad NP (year 0-2)

$110,000

gross/year

Est. take-home (TX):

$85,973

BSN→MSN/DNP · ANCC/AANP cert · entry primary care or specialty

Mid-Career NP (3-7 years)

$130,000

gross/year

Est. take-home (TX):

$99,857

FPA states higher · MD-collaboration RPA states · 1099 telehealth side income common

Senior NP / Specialty (8-15 years)

$155,000

gross/year

Est. take-home (TX):

$116,945

PMHNP / acute care / aesthetic / dermatology specialty · partnership track

NP Owner / Solo Practice / Aesthetic (15+ years)

$215,000

gross/year

Est. take-home (TX):

$159,846

FPA-state solo practice · cash-pay aesthetic · S-corp + Solo 401(k) + Section 199A QBI

Specialties & Salary Premiums

SpecialtyEst. SalaryPremium
PMHNP (Psychiatric-Mental Health)$200,694+55%
CRNA (Nurse Anesthetist) — sister APRN track$271,908+110%
Aesthetic NP (Botox / fillers / med spa)$187,746+45%
Acute Care NP (ICU / step-down hospitalist)$168,324+30%
Dermatology NP$174,798+35%
Telehealth NP (Hims/Hers/Talkiatry/Done)$155,376+20%
New Grad NP (year 0-2)$103,584-20%

Best States for Nurse Practitioners — Real Take-Home Pay

Ranked by estimated take-home pay (single filer, no additional deductions). The highest gross salary doesn't always mean the most money in your pocket.

Nurse Practitioner Salary by State — All 50 States

Take-home estimates for a single filer with no additional deductions. Click any state for the full breakdown.

StateGross SalaryEst. Take-Home
1Washington
$145,000$110,110
$158,000$105,696
3Alaska
$138,000$105,325
4Nevada
$138,000$105,325
$145,000$103,610
$145,000$101,205
7New Hampshire
$130,000$99,857
$138,000$99,175
$132,000$98,299
$138,000$97,490
11Texas
$125,000$96,440
$130,000$95,257
$130,000$94,797
$130,000$94,395
$138,000$93,148
$125,000$93,063
$128,000$92,897
$132,000$90,694
$122,000$90,644
$122,000$90,002
$122,000$89,842
$132,000$89,700
$122,000$89,521
24Florida
$115,000$89,491
25South Dakota
$115,000$89,491
26Tennessee
$115,000$89,491
27Wyoming
$115,000$89,491
$118,000$89,026
$122,000$88,718
$122,000$88,504
$118,000$88,357
$122,000$88,290
$122,000$88,237
$118,000$86,709
$122,000$86,257
$118,000$85,627
$118,000$85,586
$118,000$85,524
$115,000$85,241
$115,000$84,741
$115,000$84,541
$115,000$84,491
$118,000$84,237
$115,000$84,001
$112,000$83,015
$112,000$81,172
$108,000$80,474
$108,000$80,381
$105,000$78,856
$105,000$78,856

Job Market Outlook

BLS projects 38% growth 2022-2032 — one of fastest-growing US occupations. Full Practice Authority adoption accelerating (NY 2022, KS 2022, NC pending) — 24 states + DC FPA as of 2026. PMHNP demand structurally durable post-2020 mental health crisis. Aesthetic NP cash-pay 1099 market expanding 15-20% annually. AANP/AACN movement to all-DNP entry by 2025-2030 raising educational barrier + comp tier. Telehealth multistate licensure (Nurse Licensure Compact NLC + APRN Compact in development) opens 1099 telepsychiatry + telehealth at scale.

Maximize Your Take-Home

401(k) — $24,500 max

Reduces taxable income dollar-for-dollar

HSA — $4,400 single

Triple tax advantage — deductible, grows tax-free, tax-free withdrawals

FSA — $3,300 max

Medical expenses with pre-tax dollars

State consideration

Moving to TX, FL, WA can save $5,000–$15,000/year in taxes

Calculate Your Exact Take-Home as a Nurse Practitioner

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Frequently Asked Questions

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Nurse Practitioner Salary by State — Detailed Pages