Neonatal Nurse Practitioner Salary By State – (2021 FIGURES)
Written By: Editorial Staff @ NursingProcess.org
Neonatal nurse practitioners are specialists in the care of medically fragile newborns. The average NNP salary is high because the demand for neonatal nurse practitioners is high: According to one study conjointly undertaken by the March of Dimes and the National Perinatal Information Center, 14.4 percent of newborns delivered in 2009-2010 needed to be admitted to a NICU or a special care nursery. NNPs play an important role in such nurseries where they function both as primary care and acute care providers.
Neonatal nurse practitioners earn some of the highest salaries among all advanced practice nurses. How much does a neonatal nurse practitioner make? This article gives a comprehensive analysis of neonatal nurse practitioner salary in 2021 and all the factors that go into determining that salary.
What Does A Neonatal Nurse Practitioner Do?
Neonatal nurse practitioners manage newborns with complex health issues such as:
Premature birth: Approximately 380,000 babies in the U.S. are born prematurely every year
. That’s approximately 9.8 percent of the nation’s live births. Intensive care beginning immediately after birth lessens the risk that premature infants will die or go on to develop chronic, long-term disabilities such as cerebral palsy, chronic lung disease, blindness, hearing loss, or developmental delays.
Genetic anomalies: Genetic birth defects affect around 3 percent of babies born in the U.S. each year
. They’re a leading cause of infant mortality
Drug addiction: More than 20,000 babies in the U.S. are born each year with dependencies on illegal or prescription drugs
. The international journal Acta Paediatrica
estimates that prenatal exposure to opiates has resulted in 7-fold increases in neonatal intensive unit care stays
Birth-related events such as meconium aspiration syndrome:
Meconium aspiration occurs when a newborn inhales a mixture of meconium and amniotic fluid at the time of birth. It occurs in approximately 5 to 10 percent of all live births
. Some infants go on to develop a chemical pneumonia related to the aspiration, and this can lead to severe illness or even death.
The day-to-day treatment of these fragile infants is carried out by registered nurses who specialize in neonatal care. Neonatal nurse practitioners oversee these neonatal nurses. They may collaborate with specialized physicians called neonatal intensivists, or they may work independently, diagnosing and evaluating patients, designing treatment plans, and prescribing medications. NNPs typically start and maintain central and intravenous lines, monitor specialized equipment like ventilators and incubators, and order and/or perform diagnostic tests. The critically important nature of these tasks is the reason why the average neonatal nurse practitioner salary is more than $110,000 a year.
Where Do Neonatal Nurse Practitioners Work?
Neonatal nurse practitioners primarily work in neonatal nurseries (NICUs), which are hospital units designed to provide care to newborns. Neonatal intensive care facilities are categorized according to acuity
• Level I/Newborn Nursery:
Level I newborn nurseries are set up to provide care for newborns who are basically healthy. They are also equipped to provide care for infants born between 35 and 37 weeks of gestation whose health status is stable and to facilitate the transfer of infants born at less than 35 weeks of gestation to a hospital unit more appropriate to those infants’ needs.
• Level II/Special Care Nursery:
Level II special care nurseries are designed to care for babies who were born before they reached 32 weeks gestation but who weigh more than 3.3 pounds. They also serve as a stepdown unit for infants who’ve graduated from more acute NICUs.
• Level III/NICU:
Level IIi neonatal intensive care nurseries treat infants of any weight or gestational age who are critically ill and who may need specialized equipment to help them breathe. Many NICU patients are premies who were born before they reached a gestational age of 32 weeks and who weigh less than 3.3 pounds.
• Level IV/Regional NICU:
Level IV NICUs have the capability to care for the most seriously ill infants, including those that require surgery for serious cardiac defects and other congenital anomalies. Area hospitals typically transfer an infant to a Level IV unit when the highest level of specialized care is required for that infant.
Level II/Special Care Nurseries located in states that grant NPs full practice authority may use neonatal nurse practitioners as senior staff members; in states that place restrictions on the NP scope of practice, NNPs in Level II nurseries will work with attending physicians although those attending physicians may not always be on site. In Level III and Level IV nurseries with acutely ill infants, complicated equipment like ventilators or ECMO (extracorporeal membrane oxygenation)
, and high patient volumes, NNPs are likely to work under the direction of a neonatologist, even in states that grant NPs full practice authority.
Additionally, you may also find NNPs working in delivery rooms, emergency rooms, developmental clinics, and primary care practices. In delivery rooms, neonatal nurse practitioners stand by to assist with infants who are likely to be born with complex medical conditions. Neonatal nurse practitioners often staff medical evacuation and transport teams as well.
What Is The Typical Work Schedule For Neonatal Nurse Practitioners?
An NNP’s work schedule depends upon the setting in which he or she works. Most hospital-based neonatal nurse practitioners work three 12-hour shifts a week though in some medical settings, they may be required to work either four or five 8-hour shifts. Hospitals are open 24 hours a day, seven days a week; so, the typical hospital-based NNP may work every other weekend and on major holidays.
The schedules of neonatal nurse practitioners who work at community-based clinics usually involve 40 hours a week, even if the clinic itself isn’t open five days a week. When they’re not seeing patients, NNPs employed by such clinics will typically be doing follow-up care or making referrals for the additional resources these infants may need. Typically, neonatal nurse practitioners who transport patients are employed by Level IV nurseries, so in addition to their regular shifts, they may spend some time on call.
What Is The Level Of Job Satisfaction For Neonatal Nurse Practitioners?
Neonatal nurse practitioners like their jobs a lot. A study
published in a 1997 issue of The Journal of Perinatal & Neonatal Nursing
found that NNPs have extremely high levels of satisfaction when it comes to their chosen profession. The factors these researchers explored included the average salary of a neonatal nurse practitioner, levels of autonomy, work-related stress, patient management, administrative support, and interdisciplinary communication. NNPs rated all factors positively.
This finding has been borne out in subsequent studies and surveys. The National Association of Neonatal Nurse Practitioners (NANNP)
conducts regular workforce surveys of certified neonatal nurse practitioners. In its 2020 Neonatal Nurse Practitioner Workforce Survey
, the NANNP found a high correlation between NNP salary and employee contentedness.
How Much Does A Neonatal Nurse Practitioner Make Per Hour?
What is the average neonatal nurse practitioner salary per hour in 2021? The average neonatal nurse practitioner salary per hour in 2021 is $53, which is a little more than 1 percent more than the average hourly wage for nurse practitioners in the U.S. as a whole ($52.42). NNPs can expect to reach this salary milestone shortly after they’ve been working for five years.
NNPs can anticipate earning $38.40 an hour after they first graduate from one of the best neonatal nurse practitioner programs
. Typically, entry-level salaries are considerably less than what NNPs will make with even a single year of experience because while NNPs may have learned hands-on skills in their graduate school program, it takes some time working with actual patients to learn management skills and clinical decision-making. At $43.92 an hour, the average neonatal nurse practitioner salary for a neonatal nurse practitioner with one to four years of experience is 14 percent more than that NNP’s entry-level salary. And by the time a neonatal nurse practitioner has been working for 20 or more years, he or she can anticipate earning an hourly wage of $72.28, which is 88 percent more than the hourly entry-level salary.
|Level of Experience|| Hourly Earnings|
|1-4 Years of Experience||$43.92|
|5-9 Years of Experience||$51.69|
|10-19 Years of Experience||$60.28|
|20 Years or More Experience||$72.28|
|Average Hourly Earnings||$53.00|
What Is The Starting Salary Of A Neonatal Nurse Practitioner?
What is the entry-level salary of a neonatal nurse practitioner in 2021? The starting neonatal nurse practitioner salary in 2021 is $79,870 annually, which breaks down to $38.40 an hour or $6,660 a month. This is approximately 1 percent higher than the entry-level salary for neonatal nurse practitioners as a whole across the U.S., which is $78,990 annually.
A number of factors affect the starting salaries that NNPs earn. Chief among these is geographical location. Cost of living and industry demand both play a significant role here. Cost of living may play a more significant role, though. One example: Just over 11 percent of all live births in Tennessee are preterm
; in contrast, only 9 percent of live births in California are preterm
. Yet in California, neonatal nurse practitioners are likely to earn entry-level compensation that’s significantly higher than they do in Tennessee. That’s because the cost of living in California
is more than 50 percent higher than it is in Tennessee.
Another factor is years of education: Nurse practitioners in every specialty who’ve earned Doctor of Nursing Practice (DNP) degrees tend to make more money than NPs with Master’s in Nursing Science (MSN) degrees
. If you’ve pursued continuing education credits related to specific aspects of medically fragile infant care, or if you’ve learned specific skills in seminars or conferences, you may also be able to negotiate a higher starting wage. The more training you have, the less training and supervision you’ll require from prospective employers.
|Per Hour||$38.40 |
What Is The Average Salary Of A Neonatal Nurse Practitioner?
What is the average salary of a neonatal nurse practitioner in 2021? If you average together the salaries that NNPs earn throughout all parts of the U.S., that amount will be $53 an hour, which multiplies out to $9,190 a month or $110,249 annually. According to the Bureau of Labor Statistics, the average mean wage for all occupations across the U.S. was $56,310
, so NNPs make nearly twice as much as the typical U.S. worker.
Why is the average NNP salary so high? First because while there are relatively few neonatal nurse practitioners, there’s a huge demand for their services. According to the American Association of Nurse Practitioners, neonatal nurse practitioners only account for 1 percent of the more than 325,000 nurse practitioners currently practicing in the U.S.
Yet more than 380,000 infants a year in the U.S. are born before they reach the gestational age of 37 weeks
. That’s nearly 10 percent of all live births in this country. The number of preterm births has also increased by 4 percent since 2014
. There has also been a rapid expansion of neonatal intensive care units. According to the Dartmouth Atlas of Neonatal Intensive Care, the number of NICU beds increased by 65 percent between 1995 and 2013
Second, many practicing NNPs may be thinking about retirement. According to the 2016 NANNP workforce survey, the average age of a neonatal nurse practitioner is 49, and 52 percent of all NNPs are older than 50
. While NANNP workforce surveys don’t collect specific information about retirement plans, a 2012 National Sample of Survey of Nurse Practitioners conducted by the Health Resources and Services Administration
found that 59 percent of NPs who are 60 years or older are planning to retire within five years
. The high average NNP salary is an incentive to keep neonatal nurse practitioners from leaving their jobs.
Neonatal Nurse Practitioner Salary By Years Of Experience
On average, the starting salary for a neonatal nurse practitioner is $38.40 an hour, which comes to $6,660 a month or $79,870 a year. By the time an NNP has accumulated one to four years of experience, he or she can plan upon earning $43.92 an hour, which comes to $7,610 a month or $91,360 a year. This is a 14 percent increase over their starting salary.
Additional increments of experience bring even greater salary increases. A five-to-nine year NNP veteran on average will earn $51.60 an hour, which comes to $8,960 a month or $107,520 a year; this is an 18 percent jump over the salaries of colleagues with one to four years of experience and a 35 percent jump over colleagues who are just beginning their careers. With 10 to 19 years of experience, you can look forward to earning $125,390 a year, which breaks down to $10,450 a month or $60.28 an hour; this is a 57 percent increase over the average entry-level neonatal nurse practitioner salary. NNPs with 20 or more years of experience make a whopping 88 percent more than NNPs who are just starting out.
Experience is important because a learning curve is often involved when it comes to applying classroom learning to a real-life situation. Experienced neonatal nurse practitioners are typically better at time management and the type of collaboration that are essential when you’re working as part of a medical team. The NICUs in which most NNPs are employed are high-pressure, fast-paced environments that can be extremely stressful places. NICU work can be physically demanding and emotionally taxing, and it takes a seasoned professional to stand up to the strains of this particular position.
| Years of Experience||Per Hour||Per Month||Per Year|
|1-4 Years of Experience||$43.92||$7,610||$91,360|
|5-9 Years of Experience||$51.69||$8,960||$107,520|
|10-19 Years of Experience||$60.28||$10,450||$125,390|
|20 Years or More Experience||$72.28||$12,530||$150,350|
Average Annual Compensation (Salary + Benefits) For Neonatal Nurse Practitioners
In addition to salaries, neonatal nurse practitioners also receive another kind of compensation from employers. This compensation, termed “benefits,” are noncash perks provided to employees over and above their salaries or wages. Benefits can have considerable cash value: On average, neonatal nurse practitioners employed in the private sector reap $46,620 worth of benefits every year; since their average base salary is $110,350 annually, this brings their total compensation package to $156,970 a year. NNPs employed by state and local governments do even better. Neonatal nurse practitioners in the public sector on average pull in $67,152 worth of benefits every year; when added to their average base salary of $109,100, this brings their total compensation package to $176,252 annually.
Employees like benefits because they are essentially untaxed income. Employers like them because they’re a way of sweetening the pot and persuading good employees to stay. Some benefits such as workers’ compensation and unemployment insurance are legally mandated, while others like medical insurance and paid vacation are awarded at the discretion of the employer.
Typically, all nurse practitioners—including neonatal nurse practitioners—get handsome benefits. In the 2015 National Nurse Practitioner Compensation Survey
conducted by the American Association of Nurse Practitioners, 77 percent of all NPs received paid vacation, 72 percent received professional liability insurance, 71 percent received health insurance, 70 percent received contributions to their retirement accounts, and 53 percent received some kind of reimbursement for professional licenses and/or certifications.
Nurse practitioner employers also utilize benefits to incentivize professional development. Seventy-two percent of NPs reported receiving reimbursement for continuing education classes, while 67 percent received leave to attend professional conferences, and 54 percent received reimbursement for registration fees they paid to attend professional conferences.
|Component||Private Industry||State and Local Government|
|Retirement and Savings||$5,337||$21,855|
|Average Annual Salary||$110,350||$109,100|
How Does Neonatal Nurse Practitioner Salary Compare To Other NP Jobs?
Neonatal nurse practitioners are among the highest-paid nurse practitioners that use the APRN Consensus Model
to define their scope of practice.
While it’s true that psychiatric-mental health NPs on average earn salaries that are 12 percent higher than the average salary of a neonatal nurse practitioner, and adult-gerontology nurses both in primary and acute care on average earn salaries that are 4 percent higher, it is also true that there’s much more variability in the salaries these other professionals earn. Many P-MHNPs and AGNPs earn considerably less than the average salary for their specialty, particularly if they work in physicians’ offices. In contrast, the overwhelming majority of NNPs are employed by medical centers, so their earning potential doesn’t show much flux.
| Rank|| Job Title|| Average Per Year|| Compared to Neonatal NP Salary|
| Number || %|
| 1|| Cardiology NP|| $136,846|| +26,597|| +24.12%|
| 2|| Psychiatric Mental Health NP|| $123,607|| +13,358|| +12.12%|
| 3|| Pediatric Psychiatric NP|| $121,965|| +11,716|| +10.63%|
| 4|| Internal Medicine NP|| $117,080|| +6,831|| +6.20%|
| 5|| Oncology NP|| $117,074|| +6,825|| +6.19%|
| 6|| Adult-Gerontology Primary Care NP|| $115,195|| +4,946|| +4.49%|
| 7|| Wound Care NP|| $114,504|| +4,255|| +3.86%|
| 8|| Adult-Gerontology Acute Care NP|| $114,468|| +4,219|| +3.83%|
| 9|| Pediatric Primary Care NP|| $113,387|| +3,138|| +2.85%|
| 10|| Pediatric Oncology NP|| $112,511|| +2,262|| +2.05%|
| 11|| Orthopedic NP|| $111,681|| +1,432|| +1.30%|
| 12|| Rheumatology NP|| $110,782|| +533|| +0.48%|
| 13|| Neonatal NP|| $110,249 || 0|| 0.00%|
| 14|| Functional Medicine NP|| $110,244|| -5|| 0.00%|
| 15|| ENT NP|| $110,118|| -131|| -0.12%|
| 16|| Hepatology NP|| $110,067|| -182|| -0.17%|
| 17|| Urology NP|| $110,000|| -249|| -0.23%|
| 18|| Endocrinology NP|| $109,840|| -409|| -0.37%|
| 19|| Gastroenterology NP|| $109,719|| -530|| -0.48%|
| 20|| Nephrology NP|| $109,665|| -584|| -0.53%|
| 21|| Integrative Medicine NP|| $109,662|| -587|| -0.53%|
| 22|| Neurology NP|| $109,566|| -683|| -0.62%|
| 23|| Pulmonary NP|| $108,199|| -2,050|| -1.86%|
| 24|| Pediatric Neurology NP|| $107,851|| -2,398|| -2.18%|
| 25|| Electrophysiology NP|| $107,762|| -2,487|| -2.26%|
| 26|| Pain Management NP|| $106,785|| -3,464|| -3.14%|
| 27|| Palliative Care NP|| $106,206|| -4,043|| -3.67%|
| 28|| Family NP|| $105,898|| -4,351|| -3.95%|
| 29|| Vascular NP|| $105,702|| -4,547|| -4.12%|
| 30|| Women's Health NP|| $103,930|| -6,319|| -5.73%|
| 31|| Genetic NP|| $103,816|| -6,433|| -5.83%|
| 32|| Diabetes NP|| $103,459|| -6,790|| -6.16%|
| 33|| Pediatric Acute Care NP|| $103,148|| -7,101|| -6.44%|
| 34|| Interventional Radiology NP|| $102,781|| -7,468|| -6.77%|
| 35|| Sports Medicine NP|| $102,627|| -7,622|| -6.91%|
| 36|| Surgical NP|| $102,222|| -8,027|| -7.28%|
| 37|| HIV NP|| $102,008|| -8,241|| -7.47%|
| 38|| Ophthalmology NP|| $100,767|| -9,482|| -8.60%|
| 39|| Dialysis NP|| $100,676|| -9,573|| -8.68%|
| 40|| Dermatology NP|| $100,562|| -9,687|| -8.79%|
| 41|| Transplant NP|| $100,331|| -9,918|| -9.00%|
| 42|| Aesthetic NP|| $99,735|| -10,514|| -9.54%|
| 43|| Emergency NP|| $99,710|| -10,539|| -9.56%|
| 44|| Holistic NP|| $99,621|| -10,628|| -9.64%|
| 45|| Infectious Disease NP|| $98,842|| -11,407|| -10.35%|
| 46|| Hospice NP|| $98,660|| -11,589|| -10.51%|
| 47|| Fertility NP|| $97,053|| -13,196|| -11.97%|
| 48|| Forensic NP|| $93,734|| -16,515|| -14.98%|
| 49|| Public Health NP|| $89,155|| -21,094|| -19.13%|
| 50|| Plastic Surgery NP|| $83,549|| -26,700|| -24.22%|
How Does Neonatal Nurse Practitioner Salary Compare To Other Similar Healthcare Jobs?
At $110,249 annually, the average neonatal nurse practitioner salary is 1 percent higher than average nurse practitioner salaries across the board ($109,249 annually.) This is less than dentists, podiatrists, optometrists and pharmacists make, but those healthcare professionals are graduates of doctoral-level programs. In May 2018, the National Organization of Nurse Practitioner Faculties
(NONPF) announced that all entry-level nurse practitioner education programs would have to shift from the MSN to the DNP by 2025. Once a DNP degree becomes the terminal educational requirement for NNPs, it is likely that the average neonatal nurse practitioner salary will become much higher.
NNPs are compensated at a considerably higher rate than ancillary healthcare professionals like physical therapists, occupational therapists, and speech-language pathologists. This is because their professional focus is upon medical recovery rather than upon rehabilitation. And while physician assistants, on the whole, may make 3 percent less than NNPs, physician assistants who specialize in neonatology are likely to earn higher salaries, particularly in states like Connecticut, Washington and Idaho, where PAs typically out-earn NPs
| Rank|| Job Title|| Average Per Year|| Compared to Neonatal NP Salary|
| Number || %|
| 1|| Dentist|| $166,403|| +56,154|| +50.93%|
| 2|| Podiatrist|| $130,496|| +20,247|| +18.36%|
| 3|| Optometrist|| $120,601|| +10,352|| +9.39%|
| 4|| Pharmacist|| $115,149|| +4,900|| +4.44%|
| 5|| Neonatal Nurse Practitioner|| $110,249 || 0|| 0.00%|
|6|| Physician Assistant|| $107,038|| -3,211|| -2.91%|
| 7|| Speech-Language Pathologist|| $98,823|| -11,426|| -10.36%|
| 8|| Veterinarian|| $96,624|| -13,625|| -12.36%|
| 9|| Occupational Therapist|| $92,159|| -18,090|| -16.41%|
| 10|| Physical Therapist|| $89,349|| -20,900|| -18.96%|
| 11|| Audiologist|| $77,939|| -32,310|| -29.31%|
| 12|| Chiropractor|| $67,745|| -42,504|| -38.55%|
AVERAGE NEONATAL NURSE PRACTITIONER SALARY BY STATE – RANKED IN THE ORDER OF HIGHEST TO LOWEST PAYING
(Based on the average salary of a Neonatal Nurse Practitioner, we have ranked each of the 50 states in the order of highest to lowest paying.)
California has the highest-paid neonatal nurse practitioners in any of the 50 states. The average neonatal nurse practitioner salary in California is $67.57 an hour or $140,540 a year. One reason why the average NNP salary in California is so high is because the Golden State has one of the highest cost of living indices in the U.S., with incredibly high housing and transportation (gasoline) costs. If the salaries NNPs earn in California weren’t high, most of these professionals couldn’t afford to live there.
Another reason, though, why NNPs make so much money in the Golden State is because the demand for their services is so high. Nine percent of California infants are born before they reach the 37 th week of gestation
. Approximately 1 in every 33 babies
is born with a birth defect like a congenital heart condition, or spina bifida, or a cleft palate that necessitates intensive care in the days after birth. In the decade between 2008 and 2017, the number of drug-exposed infants born every year nearly tripled
. To care for these medically fragile newborns, California has 154 NICUs
which need staff and experienced staff managers.
| Hourly|| $67.57|
| Annual|| $140,540|
2. New Jersey
There are 38 neonatal intensive care units in New Jersey
: 19 are Level II, 18 are Level III, and one is Level IV. More than 15 of these NICUs are associated with hospitals in the greater New York City metropolitan area.
New Jersey’s relatively high NICU density (given the size of the state) is driven by the number of medically fragile infants born there every year. In the Garden State, 10 percent of all infants are born prematurely
. Moreover, approximately one in every 33 New Jersey babies is born with a specific birth defect
such as a congenital heart anomaly, a cleft lip or cleft palate, or spina bifida. The number of newborns in New Jersey affected by their mothers’ use of drugs or alcohol is rising, too; in 2016, 685 babies were born with neonatal abstinence syndrome in the Garden State
NNPs have the specialized education to manage and care for infants such as the above-mentioned ones and give them the best chance at having a normal life. The average salary for neonatal nurse practitioners in New Jersey is $60.59 an hour or $126,020 annually. NNPs are in high demand in the Garden State, and the cost of living is very high; high salaries offer neonatal nurse practitioners an incentive to stay in the state.
| Hourly|| $60.59|
| Annual|| $126,020|
At 8.5 percent, Washington’s preterm birth is relatively low. The state has seen a rise in birth defects over the past six years affecting neural tube formation
The average neonatal nurse practitioner salary in Washington is $58.54 an hour or $121,770 annually. Although many parts of the Evergreen State have a low cost of living, the cost of living index in the area around the east shore of Puget Sound is high, and most of the Evergreen State’s 27 NICUs
where NNPs are likely to work are clustered on the east shore of Puget Sound between Seattle and Olympia.
| Hourly|| $58.54|
| Annual|| $121,770|
4. New York
Most of New York State’s 76 neonatal intensive care units
are clustered in the greater New York City metropolitan area. Life is expensive in the Big Apple, and the average NNP salary in New York reflects this. The average neonatal nurse practitioner salary in New York is $58.53 an hour, which works out to $121,740 a year.
The NNPs who staff New York State NICUs have their hands full. More than 9 percent of live births in the Empire State occur before the infant has reached a gestational age of 37 weeks
. This statistic is even higher for members of New York State’s Black community, where preterm births comprise nearly 13 percent of all live births. While the number of newborns with Neonatal Abstinence Syndrome is on the decline, drug-addicted babies still comprise a significant portion of NICU admissions, as do babies born with congenital birth defects.
As recently as 2019, New York had five neonatal nurse practitioner programs: Due to the COVID pandemic, all but the program at the University of Rochester
are currently closed.
| Hourly|| $58.53|
| Annual|| $121,740|
The average salary of a neonatal NP in Massachusetts is $58.35 an hour, which amounts to $121,360 a year. Surprisingly, Massachusetts doesn’t have a Level IV NICU
; the state has 19 Level II special care nurseries and 10 Level III neonatal intensive care nurseries, so there are plenty of employment opportunities for neonatal nurse practitioners. Since Massachusetts is a full practice state, some NNPs may be employed in Level II nurseries in a supervisory capacity. The majority of the Bay State’s NICUs are in the Boston area or elsewhere near the Atlantic coast.
Nine percent of all live births in the Bay State are premature
. That equals one in every 11 babies. 7.6 percent of all Massachusetts births are considered low birthweight
, and Black babies are twice as likely as white babies to be low birthweight. There’s a great need for the services NNPs are trained to provide in the Bay State.
| Hourly|| $58.35|
| Annual|| $121,360|
There are just 12 neonatal intensive care units in Nevada
, and all of them are clustered within the greater Las Vegas metropolitan area. Nevada neonatal nurse practitioners may not have a huge number of employment options to choose from, but they do get paid well: $55.50 an hour or $115,430 a year is the average NNP salary in Nevada. At nearly 11 percent
, the Silver State’s premature birth rate is one of the nation’s worst
| Hourly|| $55.50|
| Annual|| $115,430|
Minnesota residents have access to some of the highest quality healthcare in the U.S., and because of this, the Land of Lakes has the second-lowest rate of premature births in the country
: Just 5,648 per 100,000 births. There are three Level IV NICUs in Minnesota as well as eight Level III NICUs and six Level II special care nurseries
, giving neonatal nurse practitioners a full spectrum of professional employment opportunities. The average neonatal nurse practitioner salary in Minnesota is $55.04 an hour, which multiplies out to $114,480 annually.
| Hourly|| $55.04|
| Annual|| $114,480|
8. Wyoming In all of Wyoming, there are only four Level II special care nurseries
. Infants in need of ventilation are likely to be transferred to Level III NICUs in Montana, South Dakota, or Nebraska. Nurse practitioners have an unfettered scope of practice in the Cowboy State, however, which means that NNPs are likely to be employed in supervisory positions in Wyoming’s four NICUs. Neonatal nurse practitioners in Wyoming can expect to earn $55 an hour or $114,390 a year.
| Hourly|| $55.00|
| Annual|| $114,390|
9. Hawaii Hawaii consistently snags the spot at the top on lists of the Healthiest State in the U.S.
The Aloha State still grapples with a preterm birth problem, though. Nearly 11 percent of all live births in Hawaii take place before the infant has reached a gestational age of 37 weeks
. There are three Level III NICUs
but no Level IV NICU on any of the islands, so it's likely neonatal nurse practitioners are employed as transport team members, working to stabilize critically ill babies who must be flown back to the mainland for more intensive care. NNPs in the Aloha State earn $54.98 an hour or $114,360 a year.
| Hourly|| $54.98|
| Annual|| $114,360|
Neonatal nurse practitioners in Oregon earn $54.90 an hour or $114,190 a year. It’s likely that many of them are associated with the Beaver State’s nine NICUs
, which include two Level IV units and seven Level III units, located in the metropolitan centers of Portland, Salem, Eugene, and Bend. At 8 percent, Oregon’s preterm birth rate
is relatively low. Approximately 1,370 infants are born in Oregon each year with congenital defects
serious enough to require hospitalization immediately after birth.
| Hourly|| $54.90|
| Annual|| $114,190|
11.Arizona In Arizona, a little more than 9 percent of all live births happen prematurely
. Many of these fragile infants end up being cared for by neonatal nurse practitioners and other qualified staff at one of the Grand Canyon State’s 27 neonatal intensive care units
. The average salary for neonatal nurse practitioners in Arizona is $54.38 an hour or $113,110 a year.
Arizona infants who’ve spent at least five days in a Level II, Level III, or Level IV nursery are eligible to participate in an innovative High-Risk Perinatal Program
facilitated by the Arizona Department of Health Services. Nursing professionals—including NNPs—visit the homes of these infants upon discharge to observe developmental progress and help parents connect with community resources.
| Hourly|| $54.38|
| Annual|| $113,110|
12.Rhode Island Ten percent of Rhode Island’s live births are preterm
, and the Ocean State is home to a Level II special care nursery and a Level III NICU
. One out of every 320 babies in Rhode Island is born with a birth defect
severe enough to require hospitalization immediately after birth. Neonatal nurse practitioners in the Ocean State can expect to earn salaries that average $54.30 an hour, which works out to $112,940 a year.
| Hourly|| $54.30|
| Annual|| $112,940|
13.New Mexico In New Mexico, the preterm birth rate hovers just above 10 percent
. The preterm birth rate for Black infants in the Land of Enchantment, however, is 29 percent higher than it is for all other demographics. There are six neonatal intensive care units in the state
, including one Level IV NICU in Albuquerque to which critically ill infants from Level II and Level III units in Santa Fe and Los Alamos are transported, likely with the assistance of an NNP-led transport team. In New Mexico, neonatal nurse practitioners can count on earning $54.18 an hour or $112,690 a year on average.
| Hourly|| $54.18|
| Annual|| $112,690|
14.Connecticut Connecticut has 17 NICUs
, including two top-ranked Level IV units: one associated with the Yale-New Haven Children’s Hospital and the other associated with the Connecticut Children’s Medical Center in Hartford. The Constitution State’s preterm birth rate is just over 9 percent
, and one out of every 1,090 babies is born with a congenital defect
severe enough to require hospitalization. The Yale School of Medicine in New Haven is sponsoring an innovative study
designed to decrease the number of drug-addicted babies born in the state. On average, neonatal nurse practitioners in Connecticut earn $54.05 an hour or $112,430 a year.
| Hourly|| $54.05|
| Annual|| $112,430|
Most neonatal nurse practitioners work in neonatal intensive care units, and Texas has the second-highest number of NICUs in the U.S. Among the Lone Star State’s 148 neonatal intensive care units
are 19 Level IV units, 72 Level III units, and 57 Level II units. Texas’s premature birth rate is 11 percent
, which means that one in nine babies in that state is born before he or she reaches 37 weeks of gestation. The rate of preterm births among African American women in Texas is nearly 50 percent higher than it is for other demographics, which physicians attribute to a lack of prenatal care.
The average neonatal nurse practitioner salary in Texas is $54.02 an hour, which works out to $112,360 a year. This is 1 percent higher than the national average. NNP salary in Texas fluctuates from region to region. Neonatal nurse practitioners in Houston make $121,130 a year, which is 10 percent more than the average NNP salary nationwide. But neonatal nurse practitioners in Dallas make only marginally more than the average Texas NNP salary, while neonatal nurse practitioners in Austin and San Antonio make 4 to 5 percent less than the average Texas NNP salary.
| Hourly|| $54.02|
| Annual|| $112,360|
16. Maryland Nearly 9 percent of Maryland infants born in 2020 could be classified as low birthweight
, and more than 10 percent of all live births between 2009 and 2019 were preterm
. These are infants who were likely candidates for specialized care in one of Maryland’s 28 neonatal intensive care units
. The average salary of a neonatal NP in Maryland is $53.34 an hour or $110,950 a year, which is just slightly more than the average neonatal nurse practitioner salary in all parts of the U.S. Maryland’s NICUs—where NNPs are most likely to work—are mostly clustered in the District of Columbia and Baltimore metropolitan areas, where the cost of living is higher than in other parts of the state.
| Hourly|| $53.34|
| Annual|| $110,950|
There are only seven NICUs in Montana
, and none of them are Level IV. Infants requiring Level IV NICU care must be transported to a nearby state, and it’s likely that neonatal nurse practitioners are an important part of those transport teams. Nearly 10 percent of live births in Big Sky Country are premature
, and 8.3 percent of babies are low birthweight. Montana neonatal nurse practitioners earn $52.94 an hour or $110,110 annually.
| Hourly|| $52.94|
| Annual|| $110,110|
With a rate of just 8.8 percent, Idaho
has one of the lowest preterm birth rates in the nation. There are 10 NICUs in Idaho
, including a Level IV neonatal intensive care unit in the state capital of Boise. Idaho is a full practice state for nurse practitioners, so you are likely to see NNPs in high administrative positions at the Gem State’s four Level II special care nurseries. In Idaho, neonatal nurse practitioners can expect to earn $52.72 an hour or $109,650 a year.
| Hourly|| $52.72|
| Annual|| $109,650|
19. Utah Utah has a preterm birth rate of 9.7 percent and a low birthweight rate of 7.4 percent
. There are 25 NICUs in the state
, most of them clustered throughout the greater Salt Lake City metropolitan area. Neonatal nurse practitioners in Utah earn $52.56 an hour, which amounts to $109,320 a year.
| Hourly|| $52.56|
| Annual|| $109,320|
20. Wisconsin Wisconsin has 29 neonatal intensive care units
, including two Level IV NICUs—one in Madison, the state capital, and one in Milwaukee, the state’s most populous city. While the state’s preterm birth rate is just over 10 percent
, the preterm birth rate among Black mothers is 50 percent higher
. A new “Healthy Women, Healthy Babies
” initiative aims to address this disparity. Wisconsin is also seeing a surge in babies born dependent on opioids and other addictive drugs
. The average salary for neonatal nurse practitioners in Wisconsin is $52.32 an hour, which multiplies out to $108,820 a year.
| Hourly|| $52.32|
| Annual|| $108,820|
Oklahoma was one of the states that was most impacted by the methamphetamine and opioid epidemics; in consequence, it has a higher-than-average rate of babies born with neonatal abstinence syndrome. Oklahoma also has one of the highest preterm birth rates in the U.S.: 11.5 percent
. There are 15 neonatal intensive care nurseries in the Sooner State
, including two Level IV NICUs—one in Tulsa and one in Oklahoma City. Neonatal nurse practitioners in Oklahoma can expect to earn $52.19 an hour, which comes to $108,550 annually.
| Hourly|| $52.19|
| Annual|| $108,550|
22. New Hampshire
At 8.2 percent, New Hampshire’s preterm birth rate is the lowest in the U.S
. The Granite State also had the lowest number of low birthweight babies among all states in the U.S. in 2019: Only 6.4 percent of New Hampshire infants weighed less than five pounds, eight ounces at birth
. New Hampshire has three Level III NICUs and three Level II special care nurseries
. An NNP in New Hampshire earns a salary of $52.06 an hour or $108,280 a year.
| Hourly|| $52.06|
| Annual|| $108,280|
In 2019, 9.4 percent of births in Delaware consisted of low birthweight infants
who are at higher risk for potentially life-threatening complications. At 10.7 percent, Delaware’s rate of premature births is also higher than the U.S. average. There are four NICUs in the First State
, including a Level IV neonatal intensive care unit in the state capital Wilmington. Neonatal nurse practitioners employed in Delaware make $51.95 an hour or $108,05 annually.
| Hourly|| $51.95|
| Annual|| $108,050|
24. Illinois The percentage of live births in Illinois born before the 37the week of gestation is a relatively high 10.7 percent
. It’s even higher in the state’s largest city, Chicago, where premature babies comprise almost 12 percent of all babies born
. Small wonder, then, that more than half of Illinois’s 74 neonatal intensive care units
are located in the Windy City, including the state’s only Level IV NICU. Preterm births in Illinois are nearly 50 percent higher among Black mothers than they are among white mothers.
Illinois also has one of the highest rates of babies born with drug withdrawal symptoms
. In 2016, nearly 3 of every 1,000 babies born in Illinois were affected by neonatal abstinence syndrome, and many experts believe that is an underestimate.
The average salary of a neonatal nurse practitioner in Illinois is $51.87 an hour or $107,890 annually, which is 2 percent lower than the national average. On average, the cost of living is less expensive in Illinois than it is in the U.S. as a whole, which is probably a key determinant here.
| Hourly|| $51.87|
| Annual|| $107,890|
25. Louisiana Louisiana has 27 neonatal intensive care units
, including two located within the greater New Orleans metropolitan region. Those NICUs are utilized: The Bayou State has the second-highest rates of both preterm births and low birthweight births in the U.S., 13.1 percent and 10.8 percent, respectively
. This may be one reason why the average NNP salary in Louisiana is $51.79 an hour or $107,720 a year. Though 2 percent below the national average for neonatal nurse practitioners in all parts of the U.S., Louisiana’s NNP pay rate is the highest in the southeast.
| Hourly|| $51.79|
| Annual|| $107,720|
26. Maine Maine has two Level 3 NICUs and two special care nurseries
. At 9 percent and 7.4 percent, respectively, the state’s preterm birth rate and low birthweight rate
are well below the national average. However, for its relatively sparse population, the Pine Tree State has a startlingly serious issue with drug-addicted newborns. In 2018, the number of Maine infants born following in utero exposure to addictive substances amounted to 7 percent of all live births
. NNPs in Maine earn $51.55 an hour, which comes to $107,430 a year.
| Hourly|| $51.65|
| Annual|| $107,430|
The average salary for neonatal nurse practitioners in Pennsylvania is $51.64 an hour or $107,410 annually. There’s considerable regional variation throughout the state: In Philadelphia, for example, the average NNP annual salary is 114,440, which is 7 percent higher than the state average. Presumably, this is because 20 of Pennsylvania’s 53 neonatal intensive care units
—including two of its six Level 4 NICUs—are clustered within the greater Philadelphia metropolitan area, and medical centers are competing with one another for neonatal nurse practitioner services.
At 13.1 percent, the preterm birth rate for African American mothers in Pennsylvania is nearly 50 percent higher than it is for white mothers (8.6 percent
). Black mothers were also twice as likely to give birth to low birthweight babies
. The combined rates for premature and low birthweight births in the Keystone State are 9.9 percent and 8.3 percent, respectively
. Neonatal abstinence syndrome is also responsible for many NICU admissions in the Keystone State: In 2016 and 2017, 15 out of every 1,000 babies born in Pennsylvania suffered from drug withdrawal
| Hourly|| $51.64|
| Annual|| $107,410|
28. North Dakota In all of North Dakota, there are only three Level III neonatal intensive care nurseries
. Perhaps that’s because the Peace Garden State has preterm birth rates and low birthweight rates that are at or below the national average ( 9.5 percent and 6.8 percent
, respectively). North Dakota neonatal nurse practitioners earn $51.42 an hour or $105,980 a year on average. While this is 3 percent below the national average for NNP salaries nationwide, keep in mind that the North Dakota cost of living index is 10 percent lower than the national average
, so NNPs here are making generous salaries.
| Hourly|| $51.41|
| Annual|| $106,940|
NNPs in Alaska earn $106,170 a year, which breaks down to $51.04 an hour. There are only three special care nurseries and one Level III NICU in the entire state
, so seriously ill newborns who require Level IV neonatal intensive care hospitalization must be transported long distances. NNPs are likely to play important roles on such transport teams. In 2019, preterm babies represented 9.7 percent of all live births in the state
| Hourly|| $51.04|
| Annual|| $106,170|
The average salary for neonatal nurse practitioners in Indiana is $50.89 an hour or $105,850 annually. NNP salaries in Indianapolis are marginally higher than the state average, but NNP salaries in Fort Wayne ( nearly $109,000 a year
) are 3 percent higher.
Indiana has 39 NICUs
, including two Level IV neonatal intensive care units, which are both in Indianapolis. Indiana’s preterm birth rate and low birthweight rate are 10.2 percent and 8.2 percent, respectively
, which puts the Hoosier State in the national midrange so far as these two markers go. But the preterm birth rate for Black mothers in Indiana is 44 percent higher than it is for mothers of any other demographic
| Hourly|| $50.89|
| Annual|| $105,850|
In 2019, 9.4 percent of Colorado babies were born at a low birthweight
, which is one of the highest low birthweight rates in the nation. To care for these infants, the Centennial State has 33 neonatal intensive care units
, including two Level IV NICUs in the greater Denver metropolitan area. The average salary of a neonatal NP in Colorado is $50.83 an hour or $105,680 a year, but this varies across the state; average NNP salaries are 3 percent higher in Denver.
| Hourly|| $50.81|
| Annual|| $105,680|
The average salary of a neonatal nurse practitioner in Virginia is $50.76 an hour or $105,580 a year. There’s considerable variation in salary throughout the state: In Alexandria, an upscale District of Columbia suburb, NNPs may average as much as $141,805
, while in far less affluent Virginia Beach, NNPs only earn $99,850 annually.
Virginia has 29 NICUs
, most of them clustered in the D.C. suburb and Richmond areas. The Old Dominion State’s premature birth rate was 9.9 percent in 2019
, but for African American infants, it was 54 percent higher
| Hourly|| $50.76|
| Annual|| $105,580|
Mississippi has the highest preterm birth rate in the nation: 14.6 percent of infants born in the Magnolia State are born prematurely
. At 12.3 percent, Mississippi also has the highest low birthweight rate in the U.S. The state has 16 NICUs
in which to care for these fragile newborns, including one Level IV neonatal intensive care nursery in Jackson. Neonatal nurse practitioners in Mississippi earn $50.71 or $105,470 annually on average, which is 4 percent lower than the average NNP salary in the U.S. though significantly higher than many other states in the southeast.
| Hourly|| $50.71|
| Annual|| $105,470|
The average neonatal nurse practitioner salary in Michigan is $50.52 an hour or $105,090 annually. Though this amount is 5 percent less than the average NNP salary throughout all parts of the U.S,, Michigan’s cost of living is more than 10 percent less than the national average, so NNPs are doing well
The Wolverine State has 30 neonatal intensive care units
—including Level IV NICUs in Ann Arbor, Detroit, and Grand Rapids. Its preterm birth rate is 10.3 percent, and its low birthweight rate is 8.7 percent
; both these significators are higher than the national average.
| Hourly|| $50.52|
| Annual|| $105,090|
35. North Carolina
In 2019, 10.7 percent of all babies born in North Carolina were born at least three weeks before their due date
. This statistic shows troubling racial disparities: the prematurity rate for African American babies is nearly 50% percent higher than it is for all other babies
. At 9.3 percent, the Tar Heel State’s low birthweight statistics exceed most other states in the nation. The rate of neonatal abstinence syndrome among North Carolina newborns is also high
To care for these fragile neonates, North Carolina has 36 neonatal intensive care units
, including nine Level IV NICUs. The average salary of a neonatal nurse practitioner in North Carolina is $50.16 an hour, which is $104,340 annually. NNP salaries vary throughout the state; neonatal nurse practitioners in Charlotte make close to the state average ($104,250), while NNPs in Raleigh make 3 percent above the state average ($107,120). That may reflect the fact that Raleigh’s cost of living index is slightly higher than the national average
while Charlotte’s is slightly lower
| Hourly|| $50.16|
| Annual|| $104,340|
36. Vermont At 8.4 percent, Vermont has one the lowest rates of preterm births in the U.S
. The Green Mountain State also has one of the lowest rates of newborns with low birthweights (6.5 percent). There is only one Level III NICU in the entire state
, and it’s in Burlington. Neonatal nurse practitioners in Vermont make $50.12 an hour, which rounds up to $104,250 annually.
| Hourly|| $50.12|
| Annual|| $104,250|
In 2019, Iowa’s rates of premature birth and low birthweight— 9.5 percent and 6.8 percent respectively
—placed the state among the nation’s worse rankings. Fourteen neonatal intensive care units throughout the state
are set up to deliver care to these medically fragile infants, including one Level IV NICU in Des Moines. The average salary for an NNP in Iowa is just under $50 an hour, which works out to $103,890 a year or 6 percent less than the average salary for NNPs nationwide.
| Hourly|| $49.95|
| Annual|| $103,890|
Two of Nebraska’s eight NICUs
are Level IV neonatal intensive care units; they’re both located in Omaha. NNP salaries in Omaha are $104,680, 1 percent higher than the average neonatal nurse practitioner salary of $103,340 ($49.68 an hour) throughout the state. In 2019, premature births comprised 10.5 percent of all live births in the Cornhusker State, and low birthrate infants accounted for 7.6 percent of all newborns
| Hourly|| $49.68|
| Annual|| $103,340|
There’s a lot of regional variation among NNPs’ salaries in Missouri. The average neonatal nurse practitioner salary in Missouri is $49.47 an hour or $102,890 a year, but in Kansas City on the shared western border with Kansas, NNP salaries are 4 percent higher ($106,530 a year) while in St. Louis on the shared eastern border with Illinois, NNP salaries are 6 percent lower ($96,411 a year
Missouri has 31 NICUs
, including three Level IV neonatal intensive care units, located in Kansas City, St. Louis, and Columbia. Missouri’s preterm birth rate of 10.9 percent and low birthweight rate of 8.8 percent
are both higher than the national average. African American mothers in Missouri are more than 50 percent more likely to give birth to infants before the 37th week of gestation than white mothers
. Preterm rates in Missouri are highest in the city of St. Louis.
| Hourly|| $49.47|
| Annual|| $102,890|
There are 45 NICUs in Georgia
set up to care for medically fragile newborns, including two Level IV neonatal intensive care units—one in Atlanta and one in Augusta. Georgia’s premature birth rate is high: 11.7 percent of all live births in the Peach State
take place before the gestational age of 37 weeks, and 10 percent of all babies born in the state meet the clinical specifications for low birth rate. Exacerbating this issue is the fact that African American infants are 50 percent more likely to be born prematurely
The average salary for neonatal nurse practitioners in Georgia is $49.17 per hour or $102,270 annually, which is 7 percent less than the national average for all NNPs. Neonatal nurse practitioners in the Atlanta region make marginally more than the average state NNP salary. All nurse practitioners, including neonatal nurse practitioners, earn their lowest salaries in the southeastern states. This may reflect the power of physician lobbies in those states, which prefer to go on thinking of nurses as doctors’ handmaidens rather than as respected colleagues with their own areas of competency.
| Hourly|| $49.17|
| Annual|| $102,270|
The average salary of an NNP in Arkansas is $49.16 an hour or $102,260 annually, which is 7 percent less than the average yearly amount neonatal nurse practitioners earn nationwide. In Arkansas, 11.9 percent of all live births
—or roughly one out of every eight births—is preterm. Arkansas also has a serious problem with newborns born addicted to opioids and other drugs
. There are 19 NICUs in Arkansas
, including one Level IV neonatal intensive care unit in Little Rock. NNPs in Arkansas make $102,260 a year, the equivalent of $49.16 an hour.
| Hourly|| $49.16|
| Annual|| $102,260|
There are 36 NICUs in Ohio
, and they’re distributed among the state’s large urban population centers in Columbus, Dayton, Cleveland, and Cincinnati. Ohio’s three Level IV neonatal intensive care units are located in Columbus, Cleveland, and Cincinnati. The average neonatal nurse practitioner salary in Ohio is $48.89 an hour or $101,700, but there’s considerable fluctuation from region to region throughout the state. In Columbus, the average NNP salary is only $99,890 annually, while in Cleveland, the average NNP pay is $97,888 a year
. In Cincinnati, though, it’s significantly higher: $111,809 a year
Ohio’s preterm and low birthweight numbers are right in the middle of the pack: 10.5 percent of all babies born in the Buckeye State are born before their 37th week of gestation
, and 8.6 percent of all newborns meet the clinical parameters for low birthweight. And like many other states, there is an enormous disparity between the number of premature babies born to Black mothers and the number of premature babies born to mothers of other ethnicities. Preterm births among African American women are 48 percent higher than for other demographics in Ohio
| Hourly|| $48.89|
| Annual|| $101,700|
43. West Virginia
West Virginia has one of the highest rates of premature birth in the U.S.: 12.6 percent of infants born in that state have not reached the 37 th week of gestation
. These frail babies are cared for in six neonatal intensive care units
. Two of these nurseries—one in Charleston and one in Morgantown—are Level IV NICUs. In West Virginia, neonatal nurse practitioners earn $48.70 an hour or $101,300 annually on average.
| Hourly|| $48.70|
| Annual|| $101,300|
44. Kansas Kansas’s premature birth rate is just over 10 percent
, but the premature birth rate among Black mothers is more than 50 percent higher than it is for all other women. Neonatal nurse practitioners in Kansas can expect to earn $48.38 an hour or $100,540 a year. Many of those NNPs work either in Kansas’s five Level III NICUs or 12 Level II special care nurseries.
| Hourly|| $48.38|
| Annual|| $100,640|
45. South Dakota South Dakota’s preterm birth rate is 9.6 percent overall
, but among Native American infants, it’s 12.7 percent—nearly 50 percent higher than for other ethnic groups. The Mount Rushmore State has three Level III NICUs
located in Rapid City and Sioux Falls. In South Dakota, neonatal nurse practitioners can plan on earning $47.71 a year or $99,240 annually.
| Hourly|| $47.71|
| Annual|| $99,240|
47. South Carolina
At 9.8 percent, South Carolina’s low birthweight rate
is the fifth-highest of the 50 states. The Palmetto State also has the eighth-highest rate of premature births (11.5 percent). There are 22 NICUs in South Carolina
, fairly evenly distributed throughout the state. The average salary for neonatal nurse practitioners in South Carolina is $46.84 an hour, which works out to $97,420 annually.
| Hourly|| $46.84|
| Annual|| $97,420|
Preterm birth rates in Florida keep rising from year to year. In 2019, 10.6 percent of all newborns in the Sunshine State were born before their 37th week of gestation
, and 8.7 percent of newborns met the clinical definition of low birthweight. Florida ranks 17th
out of the 50 states in terms of these significant neonatal indicators.
To meet the needs of these medically fragile newborns, there are 69 neonatal intensive care units in the Sunshine State
. Five of these are Level IV NICUs, located in the urban areas of Miami, St. Petersburg, Tampa, and Gainesville. Florida has one of the lowest pay rates for NNPs in any of the 50 states; the average neonatal nurse practitioner salary in Florida is $46.78 an hour, which multiplies out to $97,300 a year; this is 12 percent less than the national average for all neonatal nurse practitioners.
NNP salary in Florida fluctuates with geographical region. NNPs in Jacksonville make $98,990 a year, which is marginally more than the state average. But neonatal nurse practitioners in Tampa only make $95,080 a year while Miami NNPs only make $93,420 a year, which is the lowest neonatal nurse practitioner salary in any of the 50 major American cities.
| Hourly|| $46.78|
| Annual|| $97,300|
The average neonatal nurse practitioner salary in Alabama is $46.19 an hour or $96,080 annually. In Alabama, 12.5 percent of all live births take place before the newborn has reached a gestational age of 37 weeks
, and 10.5 percent of all newborns meet the clinical criteria for low birthrate. There are 20 NICUs in the Yellowhammer State
, including two Level IV neonatal intensive care units, which are both in Birmingham.
| Hourly|| $46.19|
| Annual|| $96,080|
Neonatal nurse practitioners in the U.S. make their lowest salaries in Tennessee. The average neonatal nurse practitioner salary in Tennessee is $46 an hour or $95,670 a year, which is 13 percent than the average NNP salary for all parts of the U.S. and 32 percent less than salaries in California, where neonatal nurse practitioners are paid the most.
In Tennessee, 11.2 percent of all infants are preterm
, and 9.1 percent of all infants are low birthweight. There are 27 NICUs in the Volunteer State
, including three Level IV neonatal intensive care units—one in Chattanooga, one in Memphis, and one in Nashville.
| Hourly|| $46.00|
| Annual|| $95,670|
Average Neonatal Nurse Practitioner Salary In 50 Major U.S. Cities
The highest-paid neonatal nurse practitioners work in the San Francisco Bay area. In Oakland and San Francisco, the average salary of a neonatal nurse practitioner in 2021 is $82.30 an hour or $171,189 annually. In fact, nearly every major city in California pays well above the average NNP salary, including Fresno ($63.62 an hour or $132,330 annually), Long Beach and Los Angeles ($66.09 an hour or $137,460), and Sacramento ($68.58 an hour or $142,640 annually.)
Neonatal nurse practitioners in Miami, Florida earn the lowest salaries nationwide. NNPs in Miami average $44.91 an hour or $93,420 a year, which is 45 percent less than what NNPs in the San Francisco Bay area earn.
Major cities where the average NNP salary is closest to the average neonatal nurse practitioner salary nationwide are Tulsa, Oklahoma and Las Vegas, Nevada.
| City|| Per Hour|| Per Year|
| Albuquerque, NM|| $50.45|| $104,930|
| Arlington, TX|| $54.04|| $112,400|
| Atlanta, GA|| $49.57|| $103,110|
| Austin, TX|| $51.65|| $107,430|
| Baltimore, MD|| $53.95|| $112,210|
| Boston, MA|| $58.75|| $122,210|
| Charlotte, NC|| $50.12|| $104,250|
| Chicago, IL|| $51.85|| $107,840|
| Colorado Springs, CO|| $47.12|| $98,000|
| Columbus, OH|| $48.02|| $99,890|
| Dallas, TX|| $54.04|| $112,400|
| Denver, CO|| $52.12|| $108,400|
| Detroit, MI|| $51.59|| $107,310|
| El Paso, TX|| $52.19|| $108,560|
| Fort Worth, TX|| $54.04|| $112,400|
| Fresno, CA|| $63.62|| $132,330|
| Houston, TX|| $58.24|| $121,130|
| Indianapolis, IN|| $50.94|| $105,950|
| Jacksonville, FL|| $47.59|| $98,990|
| Kansas City, MO|| $51.22|| $106,530|
| Las Vegas, NV|| $53.47|| $111,220|
| Long Beach, CA|| $66.09|| $137,460|
| Los Angeles, CA|| $66.09|| $137,460|
| Louisville, KY|| $48.99|| $101,900|
| Memphis, TN|| $50.66|| $105,370|
| Mesa, AZ|| $53.85|| $112,000|
| Miami, FL|| $44.91|| $93,420|
| Milwaukee, WI|| $51.80|| $107,750|
| Minneapolis, MN|| $55.54|| $115,530|
| Nashville, TN|| $45.63|| $94,920|
| New Orleans, LA|| $52.28|| $108,750|
| New York, NY|| $61.74|| $128,420|
| Oakland, CA|| $82.30|| $171,180|
| Oklahoma City, OK|| $52.55|| $109,310|
| Omaha, NE|| $50.33|| $104,680|
| Philadelphia, PA|| $55.02|| $114,440|
| Phoenix, AZ|| $53.85|| $112,000|
| Portland, OR|| $54.77|| $113,930|
| Raleigh, NC|| $51.50|| $107,120|
| Sacramento, CA|| $68.58|| $142,640|
| San Antonio, TX|| $51.18|| $106,450|
| San Diego, CA|| $58.38|| $121,430|
| San Francisco, CA|| $82.30|| $171,180|
| San Jose, CA|| $70.93|| $147,540|
| Seattle, WA|| $59.69|| $124,160|
| Tampa, FL|| $45.71|| $95,080|
| Tucson, AZ|| $55.90|| $116,270|
| Tulsa, OK|| $53.18|| $110,610|
| Virginia Beach, VA|| $48.00|| $99,850|
| Washington, DC|| $55.04|| $114,490|
What Is The Outlook Like For Neonatal Nurse Practitioner Salary?
Typically, in labor markets, when a profession is in short supply but in high demand, wages rise to attract workers into the profession.
Seventy-three percent of the neonatal nurse practitioner employers queried in the 2016 Neonatal Nurse Practitioner Workforce Survey
reported that there weren’t enough available NNPs to cover their practice needs. These same employers also reported they expected this situation to worsen over the next ten years. Neonatal nurse practitioner educational programs are costly for the schools that operate them, and many academic institutions that once offered this advanced practice specialty have cut back. As of 2017, only 33 collegiate programs existed that prepared advanced practice nurses for the care of critically ill newborns
Additionally, neonatal nurse practitioner students enrolled in graduate degree programs are having a difficult time finding qualified NNPs to serve as clinical preceptors. All NNPs must clock a minimum of 600 hours of direct patient care clinical education in their NNP program in order to be eligible to take their certification exam. The COVID pandemic has complicated the situation even further. Many top-ranked neonatal nurse practitioner graduate degree programs closed during the past 20 months. Whether those closures will be temporary remains to be seen.
NNPs are high-demand specialists that continue to be in extremely short supply. This is strong evidence that the average neonatal nurse practitioner salary will keep rising.
5 Ways Neonatal Nurse Practitioners Can Increase Their Earning Potential
Neonatal nurse practitioners who are looking for ways to boost their bottom lines have several options.
1. Pursue new work experiences:
NICU jobs can be highly competitive. The more specific skills you have, the more likely you are to be considered for bonuses and raises. Volunteer for assignments with types of patients you haven’t cared for before to gain new clinical competencies.
2. Choose the right continuing education opportunities:
From seminars exploring the latest advances in newborn screening technologies to workshops on ECG interpretation, a wealth of continuing education classes are available to you, which will enhance your knowledge base and help you become more marketable.
Talk to a local nursing school about teaching in an adjunct position. The healthcare facility where you work may also be looking for clinical instructors to lead inservices.
4. Go back to school:
If you presently hold an MSN degree, consider going back to school to earn a DNP degree. According to a 2018 survey
conducted by Lippincott Solutions, a division of the information services company Walters Kluwer, advanced practice nurses with DNP degrees on average earn $7,000 more each year than advanced practice nurses with MSN degrees.
There’s a huge amount of variation in the average neonatal nurse practitioner salary from state to state. If you live in a state where the lowest-paid neonatal nurse practitioners work, consider relocating to a state where NNPs earn higher wages.
Summing It Up
How much does a neonatal nurse practitioner make? As this article shows, NNPs, for the most part, are handsomely compensated for their expertise. But while it’s true that NNPs are among the most highly paid advanced practice nurses, the average salary of a neonatal nurse practitioner in 2021 shouldn’t be the prime motivating factor in your decision to become a neonatal nurse practitioner.
Providing care to high-risk infants as well as support and education to their families is a highly specialized area of expertise, and it’s not for everyone. Frequently, you’ll find yourself acting as a buffer between physicians and families during moments of extreme stress. Your patience, compassion, and communication skills will be tested as often as your clinical competencies. If you’re prepared to take on these challenges, then the NNP profession can be a tremendously rewarding one.
TOP QUESTIONS ANSWERED BY OUR EXPERT
1. How many hours a week do Neonatal Nurse Practitioners work?
The practice setting an NNP is employed in will determine the number of hours that he or she works. In medical centers, neonatal nurse practitioners are most likely to work 36 hours a week, divided into three 12-hour shifts. NNPs who work in hospitals are also likely to be required to work every other weekend and some holidays. Neonatal nurse practitioners who are part of transport teams will spend time on call.
NNPs who work in clinics and private practices will probably be required to work 40 hours a week. They may be required to work an occasional weekend day if their place of employment is open on weekends.
2. In which Settings do Neonatal Nurse Practitioners get paid the most?
Hospital-based NNPs earn the highest salaries.
3. What types of Neonatal Nurse Practitioners get paid the most?
There are no subspecialties within the neonatal nurse practitioner specialty. The average neonatal nurse practitioner salary varies according to geographical location, experience, practice setting, and education.
4. How does the salary of a Neonatal Nurse Practitioner Compare to the average Nurse Practitioner salary in the U.S?
At every tier of experience, the average neonatal nurse practitioner salary is approximately 1 percent more than the average nurse practitioner salary across the board nationwide.
| Level of Experience|| Neonatal NP|| Nurse Practitioner|| Difference|
| Number|| %|
| Starting (Entry-Level)|| $79,870|| $78,990|| +$880|| +1.10%|
| 1-4 Years of Experience|| $91,360|| $90,340|| +$1,020|| +1.12%|
| 5-9 Years of Experience|| $107,520|| $106,330|| +$1,190|| +1.11%|
| 10-19 Years of Experience|| $125,390|| $124,000|| +$1,390|| +1.11%|
| 20 Years or More Experience|| $150,350|| $148,680|| +$1,670|| +1.11%|
| Average Salary|| $110,249 || $109,025 || +$1,224|| +1.11%|
5. What are the 10 highest and lowest paying states for Neonatal Nurse Practitioners?
The highest-paid neonatal nurse practitioners work in California, New Jersey, Washington, New York, Massachusetts, Nevada, Minnesota, Wyoming, Hawaii, and Oregon.
The lowest-paid neonatal nurse practitioners work in Arkansas, Ohio, West Virginia, Kansas, South Dakota, Kentucky, South Carolina, Florida, Alabama, and Tennessee.
| Rank|| Highest Paying States || Lowest Paying States |
| State|| Annual Salary|| State|| Annual Salary|
| 1|| California|| $140,540|| Tennessee|| $95,670|
| 2|| New Jersey|| $126,020|| Alabama|| $96,080|
| 3|| Washington|| $121,770|| Florida|| $97,300|
| 4|| New York|| $121,740|| South Carolina|| $97,420|
| 5|| Massachusetts|| $121,360|| Kentucky|| $98,650|
| 6|| Nevada|| $115,430|| South Dakota|| $99,240|
| 7|| Minnesota|| $114,480|| Kansas|| $100,640|
| 8|| Wyoming|| $114,390|| West Virginia|| $101,300|
| 9|| Hawaii|| $114,360|| Ohio|| $101,700|
| 10|| Oregon|| $114,190|| Arkansas|| $102,260|
6. Which state in the Nation pays the highest average annual salary for Neonatal Nurse Practitioners?
Neonatal nurse practitioners in California earn $140,540 a year, which is the highest average annual NNP salary nationwide.
7. Which State in the Northeast pays the most for Neonatal NPs?
NNPs in New Jersey earn $128,020 a year on average, making New Jersey the highest-paying state in the northeast in terms of neonatal nurse practitioner salary.
8. Which State in the Midwest pays the most for Neonatal NPs?
Neonatal nurse practitioners in Minnesota earn $114,480 a year on average, making Minnesota the highest-paying state in the Midwest when it comes to neonatal nurse practitioner salaries.
9. Which State in the Southeast pays the most for Neonatal NPs?
Among the southeastern states, Louisiana offers neonatal NNPs the highest compensation. Neonatal nurse practitioners in the Bayou State earn $107,720 a year on average.
10. Which State in the Southwest pays the most for Neonatal NPs?
In the southwest, Arizona is the state where NNPs command the highest salaries. Neonatal nurse practitioners in the Grand Canyon State earn $113,110 annually on average.
11. Which State in the Western region pays the most for Neonatal NPs?
NNPs in California can expect to earn $149,540 a year on average, which is the highest salary paid to neonatal nurse practitioners in the western region of the U.S.
12. Among the 50 Largest Cities in the Nation, what are the 10 highest and lowest paying cities for Neonatal NPs?
U.S. cities where neonatal nurse practitioners can expect to earn the highest salaries include Oakland, CA; San Francisco, CA; San Jose, CA; Sacramento, CA; Long Beach, CA; Los Angeles, CA; Fresno, CA; New York, NY; Seattle, WA; and Boston MA.
U.S. cities where NNPs earn the least amount of compensation include Charlotte, NC; Atlanta, GA; Louisville, KY; Columbus, OH; Virginia Beach, VA; Jacksonville, FL; Colorado Springs, CO; Tampa, FL; Nashville, TN; and Miami, FL.
| Rank|| Highest Paying Cities|| Lowest Paying Cities|
| City|| Salary|| City|| Salary|
| 1|| Oakland, CA|| $171,180|| Miami, FL|| $93,420|
| 2|| San Francisco, CA|| $171,180|| Nashville, TN|| $94,920|
| 3|| San Jose, CA|| $147,540|| Tampa, FL|| $95,080|
| 4|| Sacramento, CA|| $142,640|| Colorado Springs, CO|| $98,000|
| 5|| Long Beach, CA|| $137,460|| Jacksonville, FL|| $98,990|
| 6|| Los Angeles, CA|| $137,460|| Virginia Beach, VA|| $99,850|
| 7|| Fresno, CA|| $132,330|| Columbus, OH|| $99,890|
| 8|| New York, NY|| $128,420|| Louisville, KY|| $101,900|
| 9|| Seattle, WA|| $124,160|| Atlanta, GA|| $103,110|
| 10|| Boston, MA|| $122,210|| Charlotte, NC|| $104,250|
13. Is the investment of time and money associated with becoming a Neonatal Nurse Practitioner worth it financially?
Working with critically ill newborns is as much a calling as it is a profession. If you have a passion for working with this vulnerable population, then becoming a neonatal nurse practitioner is well worth the investment of time and money. You will be well compensated financially, and you will have an enormous positive impact on the subsequent lives of the infants you care for.
We have used the following sources to compile the salary data on this page.
3. U.S. Bureau of Labor Statistics
4. NP Editorial Assessment