Nurse Practitioner Salary in North Carolina for 2024

Written By: Pattie Trumble, MPP, MPH

In North Carolina, the clinical role of nurse practitioners is statutorily restricted. The Tar Heel State will only allow NPs to function if they work within the framework of a collaborative practice agreement they maintain with a supervising physician. The physician need not work at the same facility as the nurse practitioner, but he or she must be “continuously available” to the NP, and that availability must be addressed in the practice agreement. The NP must also meet regularly with the supervising physician—once a month for the first six months and once every six months thereafter. In North Carolina, then, nurse practitioners are essentially overseen by both the North Carolina Nursing board and the state Medical Board.

In functional terms, what this means is that NPs cannot practice in areas that lack sufficient numbers of physicians to oversee them even though such medically underserved areas are the places where NP services are likely to have the most benefit. Issues like this have an impact on the salary that North Carolina nurse practitioners are able to earn throughout various parts of the state. How much does a nurse practitioner make in North Carolina? Keep reading to find out more about nurse practitioner salary in North Carolina for 2024.

What is the Starting Salary of a Nurse Practitioner in North Carolina?

As an entry-level nurse practitioner in North Carolina, you’ll earn $45.67 an hour, which calculates out to $94,990 a year or $7,920 a month. Starting salaries are heavily influenced by the cost of living in various job locations; thus, if your first job is in Charlotte, your entry-level nurse practitioner salary in North Carolina will probably be higher than it would be if your first job was in New Bern.

Other factors that influence starting salaries include core specialty, practice settings and education. If you’ve graduated from one of the best nurse practitioner programs in North Carolina, for example, an employer may be so eager to recruit you that you’ll be offered a hiring bonus if not a higher starting nurse practitioner salary in North Carolina. In most instances, hospitals will offer you a higher starting wage than a physician’s office will. If you happen to have past experience and/or certifications in specialty areas like oncology, orthopedics or cardiac practice, the starting salary you’re offered may be higher still.

What is the Average Salary of a Nurse Practitioner in North Carolina?

What is the average salary of a nurse practitioner in North Carolina? The average salary of a nurse practitioner in North Carolina is $114,450 annually, which is the equivalent of $9,540 a month or slightly more than $55 an hour. While this is nearly 8 percent less than the average U.S. nurse practitioner salary of $124,680 a year, it is more than twice the annual mean wage for all occupations in the Tar Heel State. Nurse practitioners are on the high end of the salary scale for all employees in this state.

Many considerations determine the average nurse practitioner salary in North Carolina. Chief among these is demand. According to the North Carolina Institute of Medicine, 80 rural counties in the Tar Heel State face drastic shortages of primary care providers. More than 25 percent of North Carolina’s population is over the age of 50, and this elderly population is living with chronic diseases such as cancer, diabetes and high blood pressure, conditions that also increase the demand for primary care providers. Currently, slightly more than 8,000 nurse practitioners practice in the Tar Heel State, and more than half of these professionals specialize in primary care.

NP specialty also plays a role. Neonatal nurse practitioners make the highest salaries among all North Carolina NPs. Preterm births account for more than 10 percent of all births in North Carolina, yet NPs with the specialized training to care for preterm infants only comprise about 4 percent of the entire NP workforce. They’re paid higher salaries because demand for their services is higher.

Nurse Practitioner Salary in North Carolina by Years of Experience

Unsurprisingly, NPs with the least amount of experience make the least amount of money. As previously noted, entry-level NPs earn $94,990 a year on average. By the time they have 20 years of experience under their belts, however, their salaries will increase by 47 percent to a yearly figure of $137,390 a year, which is $11,450 a month or just over $66.05 an hour.

According to the North Carolina Department of Commerce, the Tar Heel State in general has a tight labor market, but the market for healthcare professionals is particularly tight. Employers compete fiercely for the services of experienced nurse practitioners and are prepared to pay handsomely for them. Even within the framework of a collaborative physician agreement, an NP is able to provide 80 to 90 percent of the care traditionally provided by a physician. The average nurse practitioner salary in North Carolina for an NP with 20 years of experience may be high, but it is still considerably less than what a doctor would be paid, so NPs are considered a cost-effective substitute for doctors.

Total Annual Nurse Practitioner Compensation (Including Other Benefits) in North Carolina

Not all compensation is awarded in the form of salary. An employee’s total compensation is a combination of benefits plus base salary. For nurse practitioners working in North Carolina, this benefits package can be quite impressive; moreover, it is not taxable, which increases its valuation to the employee. In addition to legally required benefits like workers’ compensation and state unemployment insurance, benefits awarded to North Carolina NPs typically include medical insurance, paid vacation, retirement contributions and allowances for continuing education.

As a nurse practitioner working for a healthcare provider affiliated with the private sector, your total benefits package will have an average cash value of $48,357, which will bring your average nurse practitioner salary in North Carolina up to $162,817 a year. If you’re working for the federal, state or local government, your benefits package will have an average cash value of $70,390 a year, which will bring your average salary up to $184,750. Government benefits almost always exceed private sector benefits packages.

Nurse Practitioner Salary in North Carolina by Practice Setting

In North Carolina’s outpatient care centers, nurse practitioners shoulder many of the responsibilities traditionally assumed by physicians. NPs perform physical exams, order diagnostic tests, write prescriptions, and diagnose, treat and manage diseases. For this, they are paid on average $59.16 an hour, which works out to $123,030 a year. NPs working in outpatient care centers earn the highest average nurse practitioner salary in North Carolina.

North Carolina hospitals offer the second-highest rate of pay to NPs. On average, an NP working in a North Carolina hospital setting will earn $118,720 a year, which is lower than $122,300, the average wage all U.S. hospital nurses earn. This relatively low wage may reflect the fact that hospital nurses in North Carolina only recently won the right to unionize.

NPs working in school settings, including universities and professional schools, earn $104,570, which is the lowest nurse practitioner salary in North Carolina among all practice settings. It’s likely, however, NPs associated with schools and universities receive a very competitive compensation package.

Nurse Practitioner Salary in North Carolina by Specialty

1. Adult-Gerontology Nurse Practitioner:

Adult-gerontology nurse practitioners on average earn just under $53.60 an hour, which works out to around $111,500 a year. As noted above, a significant portion of North Carolina’s residents are over the age of 50, and AGNPs are specially trained to work with these members of the population. Most AGNPs in North Carolina are employed by hospitals in metropolitan areas like Charlotte, Raleigh and Greensboro.

Hourly	$53.60
Annual	$111,500

2. Aesthetic Nurse Practitioner:

Aesthetic nurse practitioners in the Tar Heel State earn $50.78 an hour or just over $105,630 a year. In addition to working in the offices of cosmetic surgeons, these NPs work in medical spas throughout the state that specialize in injectables, laser procedures and other cosmetic procedures. Before you can practice as an aesthetic nurse practitioner in North Carolina, you must pass the Certified Aesthetic Nurse Specialist (CANS) examination.

Hourly	$50.78
Annual	$105,630

3. Dermatology Nurse Practitioner:

Dermatology nurse practitioner jobs in North Carolina are concentrated in larger urban centers like Charlotte, Raleigh and Greensboro. The average dermatology nurse practitioner salary in North Carolina is $56.37 an hour or $117,240 a year. In order to become a dermatology NP in the Tar Heel State, you must accumulate 2,000 hours of clinical practice and then sit for the Dermatology Nurse Practitioner Certification Boards administered by the Dermatology Nurses Association.

Hourly	$56.37
Annual	$117,240

4. Emergency Nurse Practitioner:

Emergency nurse practice is one of the higher paying NP specialties in North Carolina. The nurse practitioner salary in North Carolina for professionals who staff emergency departments is $57.61 an hour or $119,830. Nearly 11 percent of North Carolina residents lack health insurance, and this percentage is increasing. People without health insurance tend to use emergency rooms for their primary healthcare needs. This may be one of the reasons why ER nurse practitioners are paid so highly.

Hourly	$57.61
Annual	$119,830

5. Family Nurse Practitioner:

The average family nurse practitioner salary in North Carolina is $116,610 annually or $56.07 per hour. Eighty of North Carolina’s 100 counties are designated primary care shortage areas, so demand for FNPs throughout the state is high. North Carolina’s Medical Society operates a Community Practitioner Program designed to recruit family nurse practitioners to underserved communities. Many of these are in more rural parts of the state.

Hourly	$56.07
Annual	$116,610

6. Neonatal Nurse Practitioner:

The highest-paid nurse practitioner in North Carolina is the neonatal nurse practitioner. In the Tar Heel State, 1 out of every 9 live births is preterm, and there is a real need for healthcare professionals with the specialized training to care for this neonate population; yet neonatal nurse practitioners comprise only 4 percent of North Carolina’s total nurse practitioner workforce. This is one of the reasons why NNPs are compensated so highly. The average neonatal nurse practitioner salary in North Carolina is $60.17 an hour, which amounts to nearly $125,170 a year.

Hourly	$60.17
Annual	$125,170

7. Pediatric Nurse Practitioner:

The average pediatric nurse practitioner salary in North Carolina is $111,080, which is 19 percent less than the average salary for pediatric nurse practitioners throughout the U.S. ($146,427). Almost half of all children in North Carolina live in households categorized as either impoverished or low-income, and these children are most likely to be found in rural areas like Hyde, Robeson and Tyrell Counties. Pediatric nurse practitioners in North Carolina play an important role in assessing and addressing the impact of poverty-related issues on child health.

Hourly	$53.40
Annual	$111,080

8. Psychiatric-Mental Health Nurse Practitioner (PMHNP):

North Carolina residents have inadequate access to mental health services. In 2017, 10 North Carolina counties had no psychiatrists at all while another 28 counties had less than one psychiatrist for every 100,000 people. Psychiatric-mental health nurse practitioners have the potential to help to bridge mental health and substance abuse treatment gaps across the state though at present, they can only work in conjunction with a psychiatrist. The average psychiatric nurse practitioner salary in North Carolina is $122,810 annually, which breaks down to $59.04 an hour.

Hourly	$59.04
Annual	$122,810

9. Women's Health Nurse Practitioner:

WHNPs provide care to women from adolescence through menopause, focusing on reproductive and gynecological health. On average, women’s health nurse practitioners earn just under $54.30 an hour or $112,950 annually in North Carolina. They’re among the lowest salary earners among NPs in the Tar Heel State because for the most part, they tend to be employed by community clinics that deal with lower-income women.

Hourly	$54.30
Annual	$112,950

Nurse Practitioner Salary in North Carolina by City

1. Charlotte:

Charlotte has a great need for the types of preventative services that NPs are expert at providing. Nearly two-thirds of the adults in Mecklenburg County—which is almost entirely comprised of the greater Charlotte metropolitan region—are overweight or obese and therefore at risk for developing diabetes, high blood pressure, cardiac problems and other weight-related conditions. Charlotte is home to prestigious hospitals like the Carolinas Medical Center and the CaroMont Regional Medical Center. The average nurse practitioner salary in Charlotte is $111,510 a year, which breaks down to $53.61 an hour.

Hourly	$53.61
Annual	$111,510

2. Raleigh:

Wake County, where Raleigh is located, is considered to be the healthiest county in the Tar Heel State. Even so, Raleigh is confronting major healthcare issues, including mental health and substance abuse disorders, and access to care. Nurse practitioners can help provide solutions to these problems. The average salary of a nurse practitioner in Raleigh, NC, is $117,800 a year, which breaks down to $56.63 an hour. Raleigh is home to Duke University and just a half-hour’s drive from the University of North Carolina in Chapel Hill, so it boasts two world-class medical centers: Duke University Hospital and the University of North Carolina Hospital System.

Hourly	$56.63
Annual	$117,800

3. Greensboro:

Greensboro has a high volume of chronic diseases like diabetes and asthma that may be preventable if positive lifestyle changes can be implemented. Additionally, mental health-related issues like depression and opioid addiction are on the rise. These are wellness challenges where nurse practitioners can make a genuine difference. Greensboro’s healthcare providers include Wake Forest Baptist Medical Center and Moses H. Cone Memorial Hospital. The average salary of a nurse practitioner in Greensboro is $54.21 an hour or $112,750 a year.

Hourly	$54.21
Annual	$112,750

4. Winston-Salem:

Winston-Salem has the worst air pollution of any city in North Carolina, and that’s linked to a higher incidence of chronic healthcare issues like asthma and other respiratory illnesses, heart attacks, stroke, cancer and mental health problems. Nurse practitioners work with Winston-Salem residents to mitigate the behavioral issues that exacerbate the effects of poor air quality. The NP salary in Winston-Salem, NC, is just over $58.98 an hour or $122,670 annually.

Hourly	$58.98
Annual	$122,670

5. Durham:

Healthcare and medical research are such major industries in Durham that one of the metropolis’s nicknames is “Medical City.” Nurse practitioners have an important role to play in combatting issues like obesity, food scarcity, mental health disorders and healthcare access. The NP salary in Durham, NC averages $58.54 an hour or $121,760 annually.

Hourly	$58.54
Annual	$121,760

NP Pay in North Carolina VS. Other Nursing Careers

With an average annual salary of $114,450, NPs in the Tar Heel State earn nearly 49 percent more than RNs without advanced practice licensure who only earn $77,420 a year. This pay differential may be large enough to persuade more RNs in North Carolina to continue their professional education although nurse practitioners seeking more autonomy are likely to be tempted to leave North Carolina and set up practice in one of the 21 states that grant nurse practitioners full practice authority.

NP Pay in North Carolina VS. Other Healthcare Careers

In terms of compensation, nurse practitioners are squarely in the middle of the salary range paid to all North Carolina healthcare providers, excluding physicians. It is likely NPs will see no significant salary increases unless North Carolina eases its practice authority laws. Though the Tar Heel State has a large medically underserved population, NPs will be constrained in their ability to serve this population without a sufficient number of physicians with whom they can enter into collaborative agreements. Demand for NP services is there, but it is still tethered to the demand for physician services.

Why is the Outlook Bright for Nurse Practitioner Salary in North Carolina?

In 2017, a bill was introduced to the North Carolina general assembly that if signed into law would eliminate the state’s physician supervision requirements for nurse practitioners. Bill 695, also known as the “Modernize Nursing Practice Act,” would not expand the current NP scope of practice but would allow nurse practitioners to practice independently, which, in turn, would allow North Carolina residents better access to the healthcare services they need. If the bill passes, nurse practitioner salaries will almost certainly rise. Even if the bill does not pass, the demand for NP services in the Tar Heel State remains high, and the most effective way to attract and retain highly-qualified professionals is by compensating them well.

Summing It Up

How much does a nurse practitioner make in North Carolina? This article has discussed the various determinants of the salary of a nurse practitioner in North Carolina for 2024 at some length. But salary is more than just an abstract figure. In a state like North Carolina where the cost of living is comparatively low, you may be able to live much more comfortably than you might on significantly higher compensation in a state where incidental expenses and outlays are skyrocketing.

TOP QUESTIONS ANSWERED BY OUR EXPERT

1. How many Nurse Practitioners are currently employed in North Carolina?

According to the U.S. Bureau of Labor Statistics, 8,040 nurse practitioners work in North Carolina.

2. How much does a nurse practitioner make per hour in North Carolina?

The average nurse practitioner salary per hour in North Carolina is $55.02. Nurse practitioners begin their careers in North Carolina averaging $45.67 an hour. By the time they have five years of experience, their salaries have increased more than 17 percent to $53.43. With 20 or more years of experience, NP salaries will increase to $66.05, which is nearly two-thirds more than the average entry-level salary.

3. How does the average salary of a nurse practitioner in North Carolina compare to the average NP salary in the U.S?

The average nurse practitioner salary in North Carolina is $114,450, which is nearly 8 percent less than the average NP salary in the U.S. ($124,680).

4. How much does a family nurse practitioner make in North Carolina?

The average FNP salary in North Carolina is $116,610, which breaks down to $56.07 an hour or $9,730 a month.

5. How much does a psychiatric nurse practitioner make in North Carolina?

The average PMHNP salary in North Carolina is $122,810, which works out to $59.04 an hour or $10,240 a month.

6. What are the 5 highest paid Nurse Practitioners in North Carolina?

Neonatal nurse practitioners in North Carolina average $125,170 a year in salary, which makes them the highest-earning NPs in the Tar Heel State. Rounding out the list of the top five NP earners in North Carolina are psychiatric-mental health nurse practitioners ($122,810), emergency nurse practitioners ($119,830), dermatology nurse practitioners ($117,240) and family nurse practitioners ($116,610).

7. What are the 5 highest paying cities for Nurse Practitioners in North Carolina?

Nurse practitioners working in Winston-Salem take home $122,670 a year on average. Other North Carolina cities where NPs can expect to make a higher salary than the state average include Durham-Chapel Hill ($121,760), Raleigh ($117,800), Jacksonville ($115,710) and Asheville ($113,610).

8. How much do Nurse Practitioners earn in the various metros of North Carolina?

North Carolina nurse practitioners command their highest salaries in Raleigh, the state capital, where they take home $117,800 annually on average. In more economically depressed communities like Jacksonville, where the number of people who live beneath the poverty line is higher than the national average, NPs only earn $115,710 a year on average.

9. Where do the majority of Nurse Practitioners practice in North Carolina?

Most nurse practitioners in North Carolina are employed in physicians’ offices. This likely reflects the fact that in the Tar Heel State, nurse practitioners can only practice through a written collaborative agreement with a physician.

10. What are the approximate number of annual job openings for nurse practitioners in North Carolina for 2023?

In order to keep up with the current demand for nurse practitioners, North Carolina will need to create 377 new NP jobs and replace 313 NPs who have chosen to leave the North Carolina workforce. This means there will be 690 annual job openings for nurse practitioners in North Carolina.

11. What is the job outlook for NPs in North Carolina?

Over the next ten years, jobs for nurse practitioners in North Carolina are projected to grow by more than 55 percent.