Nurse Practitioner Salary in Virginia (2026)
The average Nurse Practitioner in Virginia earns around $122,000/year. After taxes, your estimated take-home is $88,399/year ($7,367/month).
Take-Home Pay Breakdown
| Category | Amount |
|---|---|
Annual Take-Home Pay | $88,399 |
Monthly Take-Home Pay | $7,367 |
Biweekly Take-Home Pay | $3,400 |
Hourly Take-Home Pay based on 2,080 hrs/year | $42/hr |
Federal Tax | $18,014 |
State Tax | $6,254 |
FICA Taxes | $9,333 |
Effective Tax Rate total taxes ÷ gross salary | 27.54% |
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Nurse Practitioner Salary Ranges in Virginia
Not all Nurse Practitioners earn the same — not even close
Virginia's NP market splits across three distinct metros. NoVA (Inova Fairfax / Inova Loudoun / Reston Hospital Center / Virginia Hospital Center) plus DC-adjacent Children's National. Richmond (VCU Health, HCA Virginia's Henrico Doctors / Chippenham, Bon Secours Mercy). Norfolk / Hampton Roads (Sentara Healthcare, CHKD pediatric, Hampton VA Medical Center). VA reached FPA in 2018 — at 5 years of full-time practice, NPs can practice independently.
New Grad NP / RN→MSN bridge graduate
$105,000–$128,000
0-2 yrs · BSN→MSN/DNP · ANCC/AANP cert · VA collaborative practice (pre-5 years)
Mid-Career FNP / AGNP (3-7 yrs FPA-eligible)
$120,000–$145,000
Primary care · approaching/at 5-year FPA threshold · academic + community
Senior Specialty NP (8-15 yrs)
$135,000–$172,000
Acute care / oncology / cardiology · Inova / VCU Health / Sentara specialty
PMHNP (Psychiatric-Mental Health)
$140,000–$185,000
Highest VA NP specialty · post-2020 mental health crisis · telepsychiatry $135-$170/hr
Aesthetic NP McLean / Tysons / Richmond West End
$140K base + 1099 owner draw $220K-$420K+
FPA-eligible solo practice · S-corp + Solo 401(k) + Section 199A QBI
Federal / Cleared NP (Walter Reed-adjacent / DoD / VA Medical Centers)
$120,000–$180,000
GS-12/13/14 federal NP · TS/SCI clearance premium for cleared roles
Academic NP — Inova / VCU Health / Sentara / CHKD
$132,000–$172,000
403(b) + 457(b) dual-shelter · VCU public-employee 401(a) + 457(b)
Telehealth NP (Talkiatry / Done / Cerebral)
$120K-$180K 1099 · $125-$165/hr
1099 + multistate licensing · VA home base or relocate-to-FL/TX domicile
CRNA (sister APRN track) — DNAP + 1-yr residency
$200,000–$245,000
Highest VA APRN comp · Inova / VCU Health / Sentara CRNA programs
Per-Diem / Float NP (VA academic)
$72-110/hr · 1099
Supplement W-2 $15K-$35K/yr · Inova / VCU Health / Sentara per-diem network
Worth knowing: VA achieved Full Practice Authority in 2018 via HB 793 — NPs with 5 years of full-time clinical practice can practice independently without a collaborating physician. The 5-year threshold is the structural VA NP career inflection — once crossed, the path to solo practice plus plus Solo opens up. The post-FPA NoVA aesthetic NP cluster (McLean, Tysons, Reston) and Richmond aesthetic NP tier (West End, Short Pump) typically operate as solo or partnership practices post-FPA achievement — senior aesthetic NPs at established practices clear $250K-$420K+ owner draw.
Virginia NP comp — Inova / VCU / Sentara, FPA scope at 5 years, federal NP path
5 yrs
VA FPA threshold (HB 793, 2018) — full-time clinical practice for independent practice
5.75%
VA top state income tax (effectively flat above $17K, no local)
$4.6K+
annual VA-vs-MD residency savings for $145K NoVA NP
Northern Virginia's NP market is anchored by Inova Health System, the largest NoVA network. Inova Fairfax Hospital is the academic flagship with strong NP scope across primary care, acute care, oncology, and pediatric specialty. Inova Loudoun, Inova Alexandria, Reston Hospital Center, Virginia Hospital Center round out the NoVA tier. The broader DC-area federal NP ecosystem includes Walter Reed adjacency, multiple VA Medical Centers, NIH Bethesda — providing distinct federal-civil-service career paths for VA-resident APRNs.
Richmond's NP market is anchored by VCU Health (the academic flagship including VCU Medical Center plus Children's Hospital of Richmond at VCU). HCA Virginia operates Henrico Doctors / Chippenham / Johnston-Willis as for-profit competitors. Bon Secours Mercy operates St. Mary's, Memorial Regional, plus broader VA / Richmond tri-cities footprint.
Norfolk / Hampton Roads' NP market is anchored by Sentara Healthcare (the dominant Hampton Roads system), Children's Hospital of the King's Daughters (CHKD — the largest pediatric medical center in eastern Virginia), and Hampton VA Medical Center. The military-medical adjacency provides federal NP career options.
OT mechanics matter for some VA NPs. Hospital-employed NPs are typically classified salaried-exempt under the professional-employee exemption — but per-diem hourly NPs, NPs in non-exempt classifications, and NPs working below the salary-basis threshold may qualify for the OBBBA federal deduction on overtime (tax years 2025-2028, $12,500/year cap single / $25,000 MFJ, MAGI phase-out $150K/$300K).
Most NPs at VA academic medical centers (Inova, VCU Health, Sentara, CHKD) are salaried-exempt and does not apply. Federal civil service NPs (GS-12/13/14 at VA Medical Centers / DoD facilities) are generally salaried-exempt as well; their compensation structure relies on FERS pension + + Roth TSP rather than OT-deduction mechanics.
VA does not break from federal for — the federal above-the-line deduction reduces federal AGI which flows through to VA's effectively-flat 5.75% tax base. State savings are automatic on top of federal for any qualifying OT-.
VA's effectively-flat 5.75% state income tax (above $17K, brackets fixed since 1990) is real but cleaner than MD's structure. There are no municipal income taxes anywhere in VA — Arlington, McLean, Reston, Tysons, Richmond, Norfolk all 0% local. The structural senior-NP arbitrage is VA-vs-MD residency for DC-corridor hospital workers. Maryland levies 5.75% state + 2-3.2% county piggyback. For a $145K NP working at NoVA hospital: NoVA-resident pays 5.75% all-in versus MoCo-resident's 8.95% combined — saves $4,650/year recurring.
Virginia for NPs — DC-corridor depth, Richmond academic, Hampton Roads military
Northern Virginia's NP market benefits from DC-corridor density — federal NP (Walter Reed adjacency, VA Medical Centers, NIH Bethesda), Inova Health System's commercial network, plus the broader medical-community ecosystem. Senior NP comp at Inova director tier ($175K-$220K) supports comfortable McLean / Vienna / Reston / Falls Church family life.
Richmond is a more conventional Mid-Atlantic city — historic core, substantive food / arts / brewing scene, much lower cost of living than NoVA. VCU Medical Center anchors academic adult and pediatric NP. HCA Virginia and Bon Secours operate as competing for-profit and nonprofit systems. Senior NP comp at $160-200K supports very comfortable Westover Hills / Museum District / Forest Hill / Henrico West End lifestyles.
Norfolk / Hampton Roads' NP market is more military-adjacent — Sentara Healthcare's dominant network plus Children's Hospital of the King's Daughters (CHKD) for pediatric specialty plus Naval Medical Center Portsmouth and Hampton VA Medical Center.
Climate is mild Mid-Atlantic — hot humid summers, real but modest winters, abundant fall color. Sun-hour totals are around national average. The Shenandoah Valley / Blue Ridge for weekend recreation, Virginia Beach for summer.
Education and academic infrastructure is strong. UVA, VCU, Virginia Tech (Blacksburg), College of William & Mary all major research universities. UVA Medical Center provides additional academic NP opportunity in Charlottesville. Public schools vary sharply — strongest (Fairfax County, Henrico West End, Virginia Beach top schools) drive substantial suburban housing premium.
How VA's 5.75% effectively-flat + 0% local + 2018 FPA reshape NP take-home
VA's effectively-flat 5.75% state income tax (above $17K, brackets fixed since 1990) functions as a flat 5.75% above the threshold for any senior NP comp. A $135K mid-career NP pays roughly $7,475 in VA state; a $200K senior PMHNP pays $11,275. There is no add-on or capital-gains preferential rate.
There are no municipal income taxes anywhere in VA. Arlington, McLean, Reston, Tysons, Richmond, Norfolk all 0% local. The clean state-only stack is the structural advantage versus MD (5.75% state + 2-3.2% county piggyback) and DC (progressive brackets up to 10.75% top). The VA-vs-MD residency arbitrage saves $3K-$8K/year for senior+ NPs working at DC-corridor hospitals.
No Tax on Overtime federal deduction (tax years 2025-2028) applies to -required overtime for non-exempt NPs. Hospital-employed NPs are typically salaried-exempt and don't qualify; per-diem hourly NPs and non-exempt classifications can qualify. The deduction caps at $12,500 single / $25,000 MFJ on premium-portion. VA does not break from federal AGI, so state-level 5.75% savings on the OT-premium tier are automatic on top of federal.
2018 FPA achievement opens path to solo practice or NP-owned medical group at 5 years of full-time practice. Combined with + Solo + Section 199A optimization, the post-FPA VA aesthetic NP cluster (McLean, Tysons, Richmond West End) is a substantive solo-practice opportunity. The 5-year threshold is the structural inflection.
Virginia generally conforms to federal Section 1202 exclusion at the state level — meaningful advantage over PA / OH / NC / NJ which decline to follow federal QSBS. For DC-adjacent biotech NP roles, this is structural state-level advantage.
VA retirement-income treatment: Social Security is fully exempt. Virginia provides an age-65+ deduction up to $12,000 per individual (subject to phase-out). Roth distributions after age 59½ are exempt. Federal civil service pension (FERS) is fully VA-state-taxable.
availability: Inova Health (private nonprofit), VCU Medical Center (public, Virginia Retirement System), Sentara Healthcare (private nonprofit), CHKD all offer + 457(b) dual-shelter. VCU public-employer NPs access VRS Hybrid Retirement Plan + 457(b) deferred comp framework. At $165K mid-career marginal rate, every $1,000 deferred saves ~$220 federal + $58 VA state = $278/year. Maxing both saves ~$13,100/year.
eligibility: most VA academic medical center NPs work for 501(c)(3) non-profit employers, qualifying for Public Service Loan Forgiveness — DNP debt of $80K-$160K typical at graduation, forgiven after 10 years of qualifying payments. Federal civil service NP career path: GS-12/13/14 at VA Medical Centers / DoD facilities provides FERS pension + + Roth TSP retirement structure. Backdoor Roth IRA $7K/year + $4,400 single / $8,750 family standard, VA state-deductible. VA529 offers state deduction up to $4,000 per account / per beneficiary / per year (no statewide cap).
- →Pursue the 2018 FPA at 5 years of full-time practice. Opens path to solo practice or NP-owned medical group plus + Solo optimization.
- →If working at any DC-corridor hospital (Inova / Walter Reed-adjacent / NoVA federal NP): live in NoVA (Arlington / McLean / Falls Church / Vienna / Reston / Fairfax / Loudoun). Saves $3K-$8K/year vs Bethesda / Silver Spring / Rockville / DC residence.
- → OT-premium deduction (tax years 2025-2028) for per-diem / non-exempt NPs working substantial OT — federal deduction caps $12,500 single / $25,000 on premium-portion. Federal + VA state savings $1,900-$3,200/year for qualifying NPs.
- →Max + dual-shelter at Inova / VCU Health / Sentara / CHKD — $47,000/year combined elective deferral.
- →Federal civil service NP career path at VA Medical Centers / DoD facilities — FERS pension + + Roth TSP retirement structure.
- → at VA non-profit hospitals — DNP debt $80K-$160K forgiven after 10 years of qualifying payments at 501(c)(3) employer.
- →Backdoor Roth IRA $7K/year + $4,400 single / $8,750 family triple-tax-advantaged. VA state-deductible matching federal. VA529 $4,000 per account / per beneficiary state tax deduction (no statewide cap).
- →Aesthetic NP + Solo + Section 199A at $200K-$280K net SE income — saves $7K-$16K/year combined. FPA scope unlocks solo-practice ownership at 5 years.
Three VA NP submarkets — what each looks like
NoVA Inova + federal NP, Richmond VCU Health, and Hampton Roads Sentara + military-adjacent are three structurally different VA NP career paths.
NoVA Inova + federal NP (Inova Fairfax / Children's National / Walter Reed-adjacent / VA Medical Centers)
Mid-career NP $122K-$148K · Senior specialty $135K-$172K · Director $158K-$220K · Federal GS-13/14 $120K-$180KInova Health System (largest NoVA network — Inova Fairfax academic flagship plus Inova Loudoun, Inova Alexandria, Inova Mount Vernon). Children's National Hospital (DC, but employs NoVA-resident NPs). MedStar Washington Hospital Center / Georgetown (DC-adjacent). Walter Reed National Military Medical Center. VA Medical Centers across NoVA. DC-area federal NP ecosystem.
NoVA's NP market combines commercial Inova network plus federal civil service depth (Walter Reed-adjacent, VA Medical Centers, NIH Bethesda commute). The VA-vs-MD residency arbitrage is the structural intra-DC-corridor lever — saves $3K-$8K/year recurring for senior NPs choosing NoVA over MoCo / DC.
Richmond VCU Health + HCA Virginia + Bon Secours
Mid-career NP $115K-$140K · Senior specialty $130K-$165K · Director $148K-$205KVCU Medical Center (academic flagship, including Children's Hospital of Richmond at VCU), HCA Virginia (Henrico Doctors / Chippenham / Johnston-Willis as for-profit competitors), Bon Secours Mercy (St. Mary's, Memorial Regional, broader VA / tri-cities footprint).
Richmond's NP market provides genuine academic depth at VCU Medical Center plus competing for-profit and nonprofit alternatives. Cost of living is materially below NoVA; senior NP comp at $160-200K supports very comfortable Henrico West End or Museum District lifestyles.
Hampton Roads Sentara + military-adjacent (CHKD / Naval Medical / Hampton VA)
Mid-career NP $112K-$138K · Senior specialty $128K-$158K · Director $145K-$200K · Federal $115K-$175KSentara Healthcare (dominant Hampton Roads network — Sentara Norfolk General, Sentara Leigh, Sentara Princess Anne, Sentara Williamsburg). Children's Hospital of the King's Daughters (CHKD — largest pediatric medical center in eastern VA). Hampton VA Medical Center. Naval Medical Center Portsmouth.
Hampton Roads' military / Navy adjacency creates a structural federal NP career path. CHKD pediatric NP specialties are competitive within the region. Cost of living is the lowest of the three VA metros.
The VA NP career arc — Inova / VCU / Sentara, FPA achievement at 5 years, retirement
Year 0-2 (New Grad NP / RN→MSN bridge / DNP): $105K-$130K total comp at Inova Fairfax / VCU Medical Center / Sentara Norfolk General / CHKD. VA collaborative practice required during pre-FPA phase. VCU School of Nursing / UVA / Hampton University / George Mason MSN/DNP pipeline supplies the regional match. Start + dual-shelter and tracking from first paycheck.
Year 2-5 (Mid-Career FNP / AGNP / Specialty / Approaching FPA): $122K-$160K. Specialization develops: primary care vs acute care vs PGY2-equivalent specialty (oncology / cardiology / pediatric / PMHNP). Approach the 5-year FPA threshold — once crossed, scope expands to independent practice. OT-premium deduction $1,500-$3,000/year applies for non-exempt NPs working substantial OT 2025-2028.
Year 5-15 (FPA-Eligible Senior NP / Federal Civil Service / Aesthetic Owner): $145K-$220K. Hospital senior specialty NP track at Inova / VCU Health / Sentara clears $155K-$200K. Federal civil service GS-14 NP $145K-$185K with FERS pension + . Post-FPA aesthetic NP solo practice opens — McLean / Tysons / Richmond West End / Norfolk Ghent practices clear $220K-$420K+ owner draw.
Year 15+ (System NP Director / Senior Aesthetic Owner / Federal SES): $185K-$420K+. NP Director / Director of Advanced Practice at Inova / VCU Health / Sentara typically clears $200K-$260K. Federal Senior Executive Service (SES) caps at ~$230K cash but with FERS pension + + Roth TSP retirement security. Senior Aesthetic NP owner with multiple satellite practices plus + Solo routinely clears $300K-$420K+ owner draw. Late-career VA-stay structurally viable.
Where Virginia NPs actually live
VA NP residential geography is dominated by school district quality, the VA-vs-MD-vs-DC tax math (always favors VA), and commute geometry to specific anchor employers (Inova Fairfax, VCU Medical Center, Sentara Norfolk).
McLean / Great Falls (Fairfax Co), VA
Top Fairfax schools · 0% local · Inova / NIH Bethesda commute · $1.2M-$3M+
Vienna / Oakton / Tysons, VA
Silver Line Metro · 0% local · top schools · Inova Fairfax commute
Reston / Herndon (Fairfax Co), VA
Silver Line Metro · 0% local · planned-mixed-use · Reston Hospital commute
Falls Church City / Pimmit Hills, VA
Inner NoVA · 0% local · top Falls Church schools · 15-min Inova / DC hospital commute
West End / Short Pump (Henrico Co, Richmond)
Top Henrico schools · 0% local · VCU Medical Center / HCA Virginia commute · $500K-$1.2M
Museum District / Forest Hill / Westover Hills, Richmond
Walkable urban · 0% local · craftsman / pre-war housing · younger NP
Virginia Beach (top schools / lifestyle)
Top VB schools · 0% local · Sentara commute 25-35 min · oceanfront · $400K-$1.2M
Chesapeake / Suffolk (Hampton Roads)
0% local · suburban family · Sentara / Naval Medical commute · $350K-$700K
NoVA suburban (McLean / Vienna / Tysons / Reston / Fairfax) covers the senior+ NP family demographic with top Fairfax County schools and Inova-system commutes. Richmond's West End (Henrico) anchors VCU Health NPs. Virginia Beach / Chesapeake suburban districts cover Sentara senior NP family life.
Is this the right move?
Virginia for NPs — who it works for
Working in your favor
- +VA achieved Full Practice Authority in 2018 (HB 793) — NPs with 5 years of full-time practice can practice independently. Major scope advantage versus most Southeastern peer states.
- +Inova Health System (NoVA's largest network) plus DC-area federal NP ecosystem provides substantive senior-NP career mobility within DC corridor
- +VCU Medical Center anchors strong Richmond academic NP with VCU School of Nursing as one of the larger US programs supplying regional match
- +Sentara Healthcare + CHKD pediatric provides genuine Hampton Roads NP career depth combined with Navy / federal-NP adjacency
- +VA flat-effective 5.75% state income tax + 0% local is significantly better than MD's 5.75% + 2-3.2% county piggyback — saves $3K-$8K/year for NoVA NPs
- +VA generally conforms to federal Section 1202 QSBS exclusion at state level — meaningful advantage over PA / OH / NC / NJ for pre-IPO biotech equity
Worth knowing before you sign
- −VA's 5.75% top rate is meaningfully above NC (3.99%) / TN (0%) / FL (0%) for senior NP comp — within Southeast, only Maryland and Georgia higher
- −Outside NoVA / Richmond / Hampton Roads, senior+ NP optionality is genuinely thin — Charlottesville (UVA) and Roanoke have small markets
- −Federal civil service pension (FERS) is fully VA-state-taxable in retirement
- −DC-corridor commute geometry is real for NoVA NPs — I-66, I-95, and the Beltway routinely worst-in-nation traffic
- −Summer humidity is real for Richmond / Hampton Roads — quality of life impact varies by individual tolerance
Job Market in Virginia
Virginia has active demand for Nurse Practitioners.
Growth outlook: BLS projects 38% growth 2022-2032 — one of fastest-growing US occupations. Full Practice Authority states (24 states + DC as of 2026) drive uniquely high NP scope + independent practice opportunity. PMHNP shortage post-2020 mental health crisis = highest specialty premium ($145K-$220K). Aesthetic NP cash-pay 1099 path uniquely lucrative.
Related job titles:
Cost of Living in Virginia
Virginia has a varied cost of living by region.
💰 Monthly take-home: $7,367
🏠 Typical rent: $1,600/mo
📊 After rent: $5,767/mo
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