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Pediatric Nurse Practitioner Salary By State – (2021 FIGURES)


Written By: Editorial Staff @ NursingProcess.org

The average pediatric NP salary is high, offering PNPs a substantial return on the investment they’ve made in their graduate education. Pediatric nurse practitioners are advanced practice registered nurses specializing in the care of infants, children, adolescents, and young adults through the age of 21. Occasionally PNPs will also care for older adults affected by illnesses such as sickle cell anemia and cystic fibrosis that initially manifested when those young adults were children. Pediatric nurse practitioners comprise fewer than 8 percent of the NP workforce according to the National Association of Pediatric Nurse Practitioners.

How much does a pediatric nurse practitioner make? This article reviews everything you need to know about pediatric nurse practitioner salary in 2021.


What Does A Pediatric Nurse Practitioner Do?


The APRN Consensus Model defines two different PNP scopes of practice: pediatric-primary care nurse practice (PNP-PCs) and pediatric-acute care nurse practice (PNP-ACs).

PNP-PCs treat routine illnesses and injuries. They also provide wellness promotion, preventative services, and health education to members of their target demographic. Often, the services they provide are ongoing so that they end up treating the same patient over a number of years. Continuity of care is particularly important in a pediatric context.

Most frequently, pediatric-primary care nurse practitioners provide these services in outpatient clinics but occasionally, they will perform these services in hospital-based clinics or on hospital wards. Negative health outcomes such as infant mortality, low birth weight, asthma, obesity, injuries, mental health problems and learning disabilities are closely associated with low-income brackets, so pediatric-primary care nurse practitioners who choose to work in medically underserved areas often find themselves battling the effects of childhood poverty. Of the nearly 18,000 pediatric nurse practitioners currently certified by the Pediatric Nursing Certification Board, approximately 85 percent or 15,300 are certified as primary care specialists.

PNP-ACs care for members of their target demographic who require hospitalization for serious illnesses or injuries, or chronic conditions. PNP-ACs occasionally focus on specialties within their field; thus, you will find pediatric oncology-acute care nurse practitioners and pediatric neurology-acute care practitioners. You’ll also find pediatric psychiatric nurse practitioners; pediatric psychiatric nurse practitioners can practice either primary care or acute care. Approximately 10 percent of pediatric nurse practitioners are certified as acute care specialists; this amounts to 1,800 PNPs. (Note that 5 percent of PNPs, or 900 PNPs, are certified both as primary care and acute care specialists.)

In addition to their medical needs, children have very specific developmental needs that are both physiological and psychological. Whether a pediatric nurse practitioner’s scope of practice is primary or acute, his or her training prepares that NP to care for a child’s health within the larger context of that child’s stage of growth on a developmental spectrum.


Where Do Pediatric Nurse Practitioners Work?


For the most part, pediatric-primary care nurse practitioners and pediatric-acute care nurse practitioners work in very different practice settings.

In 2012, the Institute of Pediatric Nursing (IPN) performed a workforce study that found 48 percent of PNP-PCs work in primary care outpatient clinics, 24 percent work in subspecialty clinics, 9.34 percent work in hospital inpatient settings, 7.36 percent work in colleges and universities, 5.85 percent work in school-based settings, 2.86 percent work in hospital emergency rooms, while a small percentage also work in home healthcare, private sector urgent care clinics, and the military. Additionally, there are pediatric-primary care nurse practitioners who own and operate their own practices, and these PNP-PCs are likely to earn the highest pediatric nurse practitioner salary.

PNP-ACs primarily work in hospital settings that provide specialized care to children such as pediatric intensive care units (PICUs), well-baby nurseries, special care nurseries, neonatal intensive care nurseries, and emergency departments. In PICUs and NICUs, they work to stabilize patients so that those patients can recover and be transferred out of intensive care. Often, stabilization may depend upon providing a range of life support services that include mechanical ventilation, dialysis, and the administration of medications that must be strictly monitored. In emergency departments, they treat children with serious injuries and life-threatening illnesses that require immediate intervention.

Pediatric-acute care nurse practitioners play an important role in dedicated children’s hospitals, which are adjuncts to large medical centers in densely populated cities that are specifically set up to serve pediatric populations. Children’s hospitals are typically divided up into units that serve children with specific medical conditions; thus, you will find pediatric oncology/hematology units, pediatric cardiology units, pediatric pulmonary units, and other specialized divisions. Children’s hospitals may also employ pediatric-primary care nurse practitioners, particularly on units that treat patients with chronic conditions that require frequent hospitalizations.


What Is The Typical Work Schedule For Pediatric Nurse Practitioners?


A pediatric nurse practitioner’s work schedule depends upon the setting in which he or she is employed. PNPs who work in physicians’ offices and outpatient clinics will typically work eight-hour days. If the practice setting accommodates working parents’ needs by staying open on weekends and early evenings, then the pediatric nurse practitioners employed there may also work weekends and early evenings. School PNPs, on the other hand, will typically work the hours their school is open to students.

Data from IPN’s 2017 Pediatric Nursing Workforce report found that 77 percent of hospital-based pediatric staff work 12-hour shifts. Hospital-based PNPs in management, however, may keep more regular business hours. Hospitals are always open for business, so hospital-based PNPs who work with patients can expect to work some weekends and holidays. Depending upon an individual hospital’s policy, they may also be expected to rotate occasionally through swing shifts (3:00 p.m. to 11:30 p.m.) and night shifts (11:00 p.m. to 7:30 p.m.) Most hospital-based PNPs earn an hourly wage, so the more hours they work, the higher their salary.


What Is The Level Of Job Satisfaction For Pediatric Nurse Practitioners?


In research presented at the 2019 meeting of the National Association of Pediatric Nurse Practitioners, pediatric nurse practitioners expressed a high degree of satisfaction with their professional roles. Pediatric nurse practitioner salary, however, was not cited as one of the sources of professional gratification. Instead, PNPs cited their status in the community, their interactions with colleagues, the one-on-one time they got to spend with patients, and the continuing variety in the types of patients with whom they were able to interact.

A larger body of research exists examining the job satisfaction of pediatric nurses generally, and, advanced practice pediatric nurses can be viewed as a subset of pediatric nurses in many important respects. In these studies, pay rate was found to be positively correlated with job satisfaction.


How Much Does A Pediatric Nurse Practitioner Make Per Hour In 2021?


What is the average pediatric nurse practitioner salary per hour in 2021? The average pediatric nurse practitioner salary per hour in 2021 is $54.51 an hour for PNP-PCs and $49.59 an hour for PNP-ACs. The average hourly salary for all nurse practitioners throughout the U.S. is $53. PNP-ACs make approximately 6 percent less than this figure while PNP-PCs make approximately 3 percent more.

Why do pediatric-acute care nurse practitioners make less per hour on average than pediatric-primary care nurse practitioners? Part of the reason may be that even in states that grant nurse practitioners full practice authority, NPs specializing in acute care are rarely if ever self-employed. On the other hand, NPs specializing in primary care have the option of working as independent contractors should they choose to affiliate with a physician or an outpatient clinic. Primary care nurse practitioners may also choose to open up a solo practice. Medscape’s 2018 APRN compensation report found that NPs who are self-employed or who work as independent contractors make more on average than NPs who are employed by a medical group, a hospital, or a private practice. Even if the number of self-employed PNP-PCs is a small subset of all pediatric nurse practitioners, these earnings may be enough to raise the average pediatric NP salary overall.

Level of Experience Hourly Earnings
PNP-PC PNP-AC
Starting (Entry-Level) $39.50 $35.93
1-4 Years of Experience $45.17 $41.09
5-9 Years of Experience $53.16 $48.37
10-19 Years of Experience $62.00 $56.40
20 Years or More Experience $74.34 $67.63
Average Hourly Earnings $54.51 $49.59


What Is The Starting Salary Of A Pediatric Nurse Practitioner In 2021?


Type PNP-PC PNP-AC
Per Hour $39.50 $35.93
Per Month $6,850 $6,230
Per Year $82,150 $74,730
What is the entry-level salary of a pediatric nurse practitioner in 2021? The starting pediatric nurse practitioner salary in 2021 was $82,150 annually for PNP-PCs and $74,730 annually for PNP-ACs. The starting salary for nurse practitioners as a whole across all parts of the U.S. is $78,990; pediatric-primary care nurse practitioners make 4 percent more than this amount while pediatric acute care nurse practitioners make 5 percent less. Both salary figures are well over twice the amount of the average entry-level salary for all occupations in the U.S., however, which is only $32,592 a year.

Entry-level salaries are predicated on a number of different factors such as education and the pay rates other employers in a particular region are offering to their new employees. At present, there’s no hard and fast terminal degree for nurse practitioners. Advanced practice nurses can start their NP careers with either a Doctor of Nursing Practice (DNP) graduate degree or a Master’s of Nursing Science (MSN) graduate degree. In 2018, the National Organization of Nurse Practitioner Faculties announced its intent to have all entry-level nurse practitioner education programs shift to the DNP model. In the meantime, however, pediatric nurse practitioners are starting out with both MSN degrees and DNP degrees—and the PNPs with DNPs are likely to earn higher starting salaries. Some employers will also pay a higher entry-level salary to entice a graduate from one of the best pediatric nurse practitioner programs to work at their facility.

Regional variation in entry-level salaries is based primarily on cost of living estimates. States like California offer a high starting pediatric nurse practitioner salary because it’s very expensive to live in the Golden State where the cost of living is nearly 50 percent higher than it is in the U.S. as a whole. In Tennessee where the average pediatric nurse practitioner salary is the lowest in the nation, the cost of living is approximately 13 percent less than the national average. Pediatric nurse practitioner starting salaries are likely to be considerably less in the Volunteer State than they are in California.


What Is The Average Salary Of A Pediatric Nurse Practitioner In 2021?


Type PNP-PC PNP-AC
Per Hour$54.51$49.59
Per Month$9,450$8,600
Per Year$113,387$103,148
(Source: ziprecruiter.com)
What is the average salary of a pediatric nurse practitioner in 2021? Again, the average salary of a pediatric nurse practitioner in 2021 depends upon whether you’re employed as a pediatric-primary care nurse practitioner or a pediatric-acute care nurse practitioner. On average, pediatric NPs who specialize in primary care earn 9 percent more a year than pediatric NPs who specialize in acute care. PNP-PCs earn $54.51 an hour on average, which multiplies out to $9,450 a month or $113,387 a year while PNP-ACs earn $49.59 an hour on average, which comes to $8,600 a month or $103,148 a year. Both types of PNPs are likely to hit this salary benchmark at some point between their ninth and tenth year of employment.

Pediatric nurse practitioners make approximately twice as much as the average wage for all workers across all parts of the U.S., which the Bureau of Labor Statistics pegs at $56,310 a year. This generous pediatric nurse practitioner salary is based upon the high demand for PNP services. According to the U.S. census, there are approximately 74 million children in the U.S., and this number will grow to 78 million by 2050. Comprehensive longitudinal primary care is important for both adults and children, but it’s particularly important for children because consistent primary care improves health outcomes later in life. Additionally, some 12.4 percent of U.S. children have special health conditions that require medical tracking and may require intermittent hospitalizations.

The National Association of Pediatric Nurse Practitioners projects that the U.S. will be looking at a critical shortage of pediatric nurse practitioners over the next decade. At present, the U.S. has approximately 18,100 PNPs, and that number is not expected to grow because the number of PNPs that retire every year is roughly in line with the number of new PNPs who become licensed every year. The average pediatric nurse practitioner salary is high because PNPs are such a cost-effective means of meeting children’s complex healthcare needs, particularly in rural and medically underserved areas where there’s a shortage of pediatricians and family care physicians.

There may also be a correlation between high pediatric nurse practitioner salary and NP practice authority. Twelve of the 20 states where pediatric nurse practitioners earn the highest salaries are states that allow NPs to practice independently, either as soon as they earn their licenses or after working with a supervising physician for a certain number of hours.


Pediatric Nurse Practitioner Salary By Years Of Experience In 2021


Nurse practitioner graduate programs are tremendously efficient at teaching the hands-on competencies that NPs will need in their clinical practice, Developing the confidence to use those skills effectively, however, is a process that takes place gradually over the first few years of a nurse practitioner’s professional career. This is why entry-level NPs, including PNPs, are not paid as highly as NPs with several years of experience.

With one to four years of experience, the average pediatric nurse practitioner salary for primary care specialists is $45.17 an hour, which works out to $7,830 a month or $93,960 a year while the average pediatric NP salary for acute care specialists is $41.09 an hour, which multiplies out to $7,120 a month or $85,470 a year. Both these figures are 14 percent higher than what these PNPs make when they are first starting out.

With five to nine years of experience, PNP-PCs earn $110,580 a year, which breaks down to $53.16 an hour or $9,220 a month, while PNP-ACs earn $100,600 a year, which works out to $48.37 an hour or $8,380 a month. Both PNP specialties earn 18 percent more with an additional four years of experience. The salary differential between the two different pediatric nurse practitioner specialties is approximately $10,000 or 10 percent

The biggest leap in earning capacity comes when pediatric nurse practitioners have been working for two decades or more. Pediatric-primary care nurse practitioners with 20+ years of experience earn $74.34 an hour, which is $12,890 a month or $154,630 a year; pediatric-acute care nurse practitioners with the same amount of experience earn $67.63 an hour, which is $11,720 a month or $140,670 a year. Both types of PNP specialists earn a full 20 percent more than colleagues with under 20 years of experience or 36 percent more than the average pediatric nurse practitioner salary for each of their specialties. This earnings hike is likely an incentive to keep these valued employees in the workforce since only 1,025 new PNPs become licensed each year.

Level of ExperiencePNP-PCPNP-AC
Per HourPer MonthPer YearPer HourPer MonthPer Year
Starting (Entry-Level)$39.50$6,850$82,150$35.93$6,230$74,730
1-4 Years of Experience$45.17$7,830$93,960$41.09$7,120$85,470
5-9 Years of Experience$53.16$9,220$110,580$48.37$8,380$100,600
10-19 Years of Experience$62.00$10,750$128,960$56.40$9,780$117,320
20 Years or More Experience$74.34$12,890$154,630$67.63$11,720$140,670


Average Annual Compensation (Salary + Benefits) For Pediatric Nurse Practitioners In 2021


Pediatric nurse practitioner compensation is not measured by salary alone. Employers routinely compensate employees above and beyond their salaries or wages with perks known as benefits. Benefits are a good deal for employees because they essentially represent nontaxable income. Two jobs that pay exactly the same salary can vary greatly in terms of this indirect type of compensation, which is one reason PNPs should never accept employment upon the basis of pediatric nurse practitioner salary alone.

Certain types of benefits such as workers’ compensation and unemployment insurance are legally mandated. Others are awarded at an employer’s discretion. From an employer’s point of view, benefits act to attract top employees. Pediatric nurse practitioners are highly sought-after employees, so employers offer benefits that routinely include health insurance, paid time off and contributions to retirement funds and may also offer less common perks such as dependent health insurance coverage, dependent care reimbursement, tuition reimbursement, and relocation assistance.

Benefits do add up. For PNP-PCs working in the private sector, the total value of benefits on average equals $47,947, bringing their total compensation package to $161,437. For PNP-ACs working in the private sector, the total value of benefits on average equals $43,616, bringing their total compensation package to $146,856.

State and local governments, on the whole, offer PNPs a lower average pediatric nurse practitioner salary but higher benefits. Thus, a PNP-PC working in the public sector earns benefits worth $69,066 annually on average, which brings his or her total compensation to $181,276 a year, while a PNP-AC working in the public sector earns benefits worth $62,831 annually on average, which brings his or her total compensation to $164,911 a year. When you factor benefits into the equation, public sector pediatric nurse practitioners earn more than their counterparts in the private sector even though their actual salaries may be lower.

Component Private Industry State and Local Government
PNP-PC PNP-AC PNP-PC PNP-AC
Paid Leave $11,946 $10,867 $13,777 $12,533
Supplemental Pay $5,650 $5,140 $1,813 $1,649
Insurance $12,592 $11,455 $21,209 $19,295
Retirement and Savings $5,489 $4,993 $22,478 $20,449
Legally Required $12,269 $11,161 $9,970 $9,070
Total Benefits $47,947 $43,616 $69,066 $62,831
Average Annual Salary $113,490 $103,240 $112,210 $102,080
Total Compensation $161,437 $146,856 $181,276 $164,911


How Does Pediatric Nurse Practitioner Salary Compare To Other NP Jobs In 2021?


Pediatric-primary care nurse practitioners rank among the top ten NP specialties in terms of pediatric nurse practitioner salary. This may be due to the fact that they’re able to perform many of the same functions as pediatricians, which makes them invaluable in locations where pediatricians are in short supply. PNP-PCs take medical histories, perform medical exams, make diagnoses, and treat illnesses and injuries the same way that pediatricians do, and when they come across a complex illness or injury that’s beyond their scope of practice, they refer that patient to a physician. Even though they are well compensated, they earn 56 percent less than the average pediatrician ($177,345), which makes pediatric-primary care nurse practitioners very cost-effective physician substitutes.

Pediatric-acute care nurse practitioners, on the other hand, earn a considerably lower average pediatric nurse practitioner salary than many other NP specialties. This may be due to the fact that even in states that grant nurse practitioners full practice authority, this specialty does not loan itself to solo practice. Most PNP-ACs work in hospital settings, and it’s likely that what they’re not paid in salary is made up for in benefits.

Rank Job Title Average Per Year Compared to PNP-PC Salary Compared to PNP-AC Salary
Number % Number %
1 Cardiology NP $136,846 +23,459 +20.69% +33,698 +32.67%
2 Psychiatric Mental Health NP $123,607 +10,220 +9.01% +20,459 +19.83%
3 Pediatric Psychiatric NP $121,965 +8,578 +7.57% +18,817 +18.24%
4 Internal Medicine NP $117,080 +3,693 +3.26% +13,932 +13.51%
5 Oncology NP $117,074 +3,687 +3.25% +13,926 +13.50%
6 Adult-Gerontology Primary Care NP $115,195 +1,808 +1.59% +12,047 +11.68%
7 Wound Care NP $114,504 +1,117 +0.99% +11,356 +11.01%
8 Adult-Gerontology Acute Care NP $114,468 +1,081 +0.95% +11,320 +10.97%
9 Pediatric Primary Care NP $113,387 0 0.00% +10,239 +9.93%
10 Pediatric Oncology NP $112,511 -876 -0.77% +9,363 +9.08%
11 Orthopedic NP $111,681 -1,706 -1.50% +8,533 +8.27%
12 Rheumatology NP $110,782 -2,605 -2.30% +7,634 +7.40%
13 Neonatal NP $110,249 -3,138 -2.77% +7,101 +6.88%
14 Functional Medicine NP $110,244 -3,143 -2.77% +7,096 +6.88%
15 ENT NP $110,118 -3,269 -2.88% +6,970 +6.76%
16 Hepatology NP $110,067 -3,320 -2.93% +6,919 +6.71%
17 Urology NP $110,000 -3,387 -2.99% +6,852 +6.64%
18 Endocrinology NP $109,840 -3,547 -3.13% +6,692 +6.49%
19 Gastroenterology NP $109,719 -3,668 -3.23% +6,571 +6.37%
20 Nephrology NP $109,665 -3,722 -3.28% +6,517 +6.32%
21 Integrative Medicine NP $109,662 -3,725 -3.29% +6,514 +6.32%
22 Neurology NP $109,566 -3,821 -3.37% +6,418 +6.22%
23 Pulmonary NP $108,199 -5,188 -4.58% +5,051 +4.90%
24 Pediatric Neurology NP $107,851 -5,536 -4.88% +4,703 +4.56%
25 Electrophysiology NP $107,762 -5,625 -4.96% +4,614 +4.47%
26 Pain Management NP $106,785 -6,602 -5.82% +3,637 +3.53%
27 Palliative Care NP $106,206 -7,181 -6.33% +3,058 +2.96%
28 Family NP $105,898 -7,489 -6.60% +2,750 +2.67%
29 Vascular NP $105,702 -7,685 -6.78% +2,554 +2.48%
30 Women's Health NP $103,930 -9,457 -8.34% +782 +0.76%
31 Genetic NP $103,816 -9,571 -8.44% +668 +0.65%
32 Diabetes NP $103,459 -9,928 -8.76% +311 +0.30%
33 Pediatric Acute Care NP $103,148 -10,239 -9.03% 0 0.00%
34 Interventional Radiology NP $102,781 -10,606 -9.35% -367 -0.36%
35 Sports Medicine NP $102,627 -10,760 -9.49% -521 -0.51%
36 Surgical NP $102,222 -11,165 -9.85% -926 -0.90%
37 HIV NP $102,008 -11,379 -10.04% -1,140 -1.11%
38 Ophthalmology NP $100,767 -12,620 -11.13% -2,381 -2.31%
39 Dialysis NP $100,676 -12,711 -11.21% -2,472 -2.40%
40 Dermatology NP $100,562 -12,825 -11.31% -2,586 -2.51%
41 Transplant NP $100,331 -13,056 -11.51% -2,817 -2.73%
42 Aesthetic NP $99,735 -13,652 -12.04% -3,413 -3.31%
43 Emergency NP $99,710 -13,677 -12.06% -3,438 -3.33%
44 Holistic NP $99,621 -13,766 -12.14% -3,527 -3.42%
45 Infectious Disease NP $98,842 -14,545 -12.83% -4,306 -4.17%
46 Hospice NP $98,660 -14,727 -12.99% -4,488 -4.35%
47 Fertility NP $97,053 -16,334 -14.41% -6,095 -5.91%
48 Forensic NP $93,734 -19,653 -17.33% -9,414 -9.13%
49 Public Health NP $89,155 -24,232 -21.37% -13,993 -13.57%
50 Plastic Surgery NP $83,549 -29,838 -26.32% -19,599 -19.00%


How Does Pediatric Nurse Practitioner Salary Compare To Other Similar Healthcare Jobs In 2021?


On average, PNP-PCs make 4 percent more than nurse practitioners across the board, but PNP-ACs make 5 percent less. Both types of pediatric nurse practitioners make less than dentists, podiatrists, optometrists and pharmacists, which may have to do with the fact that these professionals are graduates of doctoral programs.

Both primary care and acute care pediatric nurse practitioners earn higher salaries than allied healthcare providers such as physical therapists, occupational therapists, and speech-language therapists. This may have to do with the fact that PNPs provide treatment while these other healthcare professionals focus on the rehabilitative services necessary to resume the activities of everyday life once treatment has been successful.

Rank Job Title Average Per Year Compared to PNP-PC Salary Compared to PNP-AC Salary
Number % Number %
1 Dentist $166,403 53,016 +46.76% +63,255 +61.32%
2 Podiatrist $130,496 17,109 +15.09% +27,348 +26.51%
3 Optometrist $120,601 7,214 +6.36% +17,453 +16.92%
4 Pharmacist $115,149 1,762 +1.55% +12,001 +11.63%
5 Pediatric Primary Care Nurse Practitioner $113,387 0 0.00% +10,239 +9.93%
6 Physician Assistant $107,038 -6,349 -5.60% +3,890 +3.77%
7 Pediatric Acute Care Nurse Practitioner $103,148 -10,239 -9.03% 0 0.00%
8 Speech-Language Pathologist $98,823 -14,564 -12.84% -4,325 -4.19%
9 Veterinarian $96,624 -16,763 -14.78% -6,524 -6.32%
10 Occupational Therapist $92,159 -21,228 -18.72% -10,989 -10.65%
11 Physical Therapist $89,349 -24,038 -21.20% -13,799 -13.38%
12 Audiologist $77,939 -35,448 -31.26% -25,209 -24.44%
13 Chiropractor $67,745 -45,642 -40.25% -35,403 -34.32%




AVERAGE PEDIATRIC NURSE PRACTITIONER SALARY BY STATE IN 2021 – RANKED IN THE ORDER OF HIGHEST TO LOWEST PAYING

(Based on the average salary of a Pediatric Nurse Practitioner in 2021, we have ranked each of the 50 states in the order of highest to lowest paying.)

1. California: The highest-paid pediatric nurse practitioners in the U.S. work in California. The average pediatric nurse practitioner salary in California for primary care specialists is $69.49 an hour or $144,540 a year, while for acute care specialists, it’s $63.22 an hour or $131,490 a year. In the San Francisco Bay area, PNP salaries average 22 percent higher than the state’s pediatric NP salary average, while in the Los Angeles area, PNP salaries average 2 percent less.

Two factors are probably responsible for the high pediatric nurse practitioner salary in California. First, California’s cost of living is more than 46 percent higher than the average cost of living for all parts of the U.S. If pediatric nurse practitioners didn’t make so much money in California, they might not be able to afford to live there. Second, the need for PNP services is high throughout the Golden State.

California has 21 dedicated children’s hospitals where the services of PNP-ACs are in great demand; this is the highest number of children’s hospitals in any state. And despite its prosperity, California has the nation’s highest rates of child poverty. The U.S. Health Resources & Service Administration (HRSA) has identified 214 medically underserved areas within the state where access to low-cost primary care services is vitally important.


TypePNP-PCPNP-AC
Hourly$69.49$63.22
Annual$144,540$131,490


2. New Jersey: Poverty is linked to negative health outcomes. New Jersey’s child poverty rate is 15.6 percent, which is well below the national average of 20 percent, but indicates the Garden State’s most vulnerable kids need better access to primary care services. Childhood obesity is an epidemic in New Jersey: Nearly one-third of the state’s 10- to 17-year-olds are overweight or obese. Many of New Jersey’s pediatric-acute care nurse practitioners are employed by one of the 21 children’s hospitals clustered throughout the New Jersey and New York parts of the greater New York metropolitan area.

The average salary for pediatric nurse practitioners in New Jersey is $62.31 an hour or $129,610 annually for pediatric-primary care nurse practitioners, and $56.68 an hour or $117,900 annually for pediatric-acute care nurse practitioners. One of the reasons why PNPs in the Garden State make such high salaries is that New Jersey-based hospitals, physician practices and community agencies must compete with high-paying New York City-based facilities for these professionals’ services.

TypePNP-PCPNP-AC
Hourly$62.31$56.68
Annual$129,610$117,900


3. Washington: An estimated 14 to 17 percent of children in Washington State aged 17 or younger have special healthcare needs, which are met by primary healthcare providers like PNP-PCs. Washington State grants nurse practitioners full practice authority, which makes it much easier for these professionals to practice in rural and medically underserved areas. The average pediatric nurse practitioner salary in Washington is $60.21 an hour or $125,240 annually for pediatric-primary care nurse practitioners, and $54.77 an hour or $113,930 for pediatric-acute care nurse practitioners; this is 10 percent above the national average. There are four children’s hospitals in the Evergreen State.

TypePNP-PCPNP-AC
Hourly$60.21$54.77
Annual$125,240$113,930


4. New York: In 2019, nearly 18 percent of New York’s children lived in poverty. The COVID-19 pandemic that began in 2020 significantly increased that number. For Black and Hispanic children, the number of children living in poverty approaches 30 percent, more than twice as high as the rate for white children. HRSA has identified 133 areas in the Empire State as medically underserved areas with insufficient access to primary healthcare providers. Clearly, there is a great demand for pediatric primary care providers across the state, and this is one reason why the average pediatric nurse practitioner salary in New York is so high. New York has 18 dedicated children’s hospitals, the second-highest number among all the states. This likely increases employment opportunities for pediatric nurse practitioners whose specialty is acute care.

The pediatric nurse practitioner salary in New York for acute care specialists is $54.75 an hour or $113,890 annually. For PNP-PCs, the average salary is $60.19 an hour or $125,200 annually. PNPs employed in the New York City metropolitan area earn 5 percent more than the average PNP state wage.

One reason why pediatric nurse practitioner salaries are so high in New York State is that there are so many potential employers, particularly within the greater New York metropolitan area (which also serves patients in New Jersey and Connecticut.) These employers are in competition with one another for PNP services, and that competition tends to drive salaries up.

TypePNP-PCPNP-AC
Hourly$60.19$54.75
Annual$125,200$113,890


5. Massachusetts: In Massachusetts, more than 90 percent of children under 19 have access to primary care services. Though children in the Bay State are generally healthy, the juvenile asthma rate is 8.4 percent, and the obesity rate is 24.2 percent. There are eight dedicated children’s hospitals in the state, most of them clustered in the greater Boston metropolitan area. Boston Children’s Hospital has been called the best pediatric hospital in the nation by U.S. New & World Report.

The salary of a pediatric nurse practitioner in Massachusetts depends upon whether that PNP specializes in primary care or acute care. PNP-PCs average $60 an hour or $124,810 a year, while PNP-ACs earn $54.59 an hour or $113,540 a year. Average salaries in the Boston area are 1 percent higher than they are elsewhere in the state.

The cost of living in Massachusetts is more than 27 percent higher than the cost of living for the U.S. as a whole , and this may have some effect on PNP salaries there. Another factor raising pediatric nurse practitioner salary averages may be that Massachusetts is a full practice state for nurse practitioners. PNPs with solo practices or who work as independent contractors may be generating enough revenue to pull up the salary average.

TypePNP-PCPNP-AC
Hourly$60.00$54.59
Annual$124,810$113,540


6. Nevada: Nearly 13 percent of Nevada’s children have no access to primary care providers, either because they live in a rural area or in a medically underserved urban neighborhood. Nevada is a state that grants full practice authority to nurse practitioners, however, so this challenge has the potential to be tackled by pediatric-primary care nurse practitioners. PNP-PCs in the Silver State make $57.07 an hour or $118,710 annually on average, while PNP-ACs make $51.92 an hour or $107,990 a year.

TypePNP-PCPNP-AC
Hourly$57.07$51.92
Annual$118,710$107,990


7. Minnesota: The international nonprofit “Save the Children” dubbed Minnesota the best state for children amid the ongoing COVID-19 pandemic. Data metrics that signal negative health status such as asthma and obesity rates are low in the Land of Lakes. Minnesota is a full-practice state for nurse practitioners, so PNPs are able to provide primary healthcare to kids living in medically underserved areas where physicians are scarce. The average pediatric nurse practitioner salary in Minnesota is 4 percent higher than it is in the rest of the country. Pediatric-primary care nurse practitioners make $56.50 an hour or $117,730 a year on average, while pediatric-acute care practitioners make $51.49 an hour or $107,100 a year. There are seven children’s hospitals in the Land of Lakes.

TypePNP-PCPNP-AC
Hourly$56.60$51.49
Annual$117,730$107,100


8. Wyoming: Wyoming is a full-practice state for nurse practitioners, so PNPs have the authority to fill any shortages in primary care providers. Pediatric-primary care nurse practitioners earn $56.56 an hour or $117,640 a year on average, while pediatric-acute care nurse practitioners earn $51.45 an hour or $107,020 a year; this is 4 percent more than the national average. There are no dedicated children’s hospitals in the Cowboy State.

TypePNP-PCPNP-AC
Hourly$56.56$51.45
Annual$117,640$107,020


9. Hawaii: Hawaii consistently ranks as one of the healthiest states in the U.S. for all age groups. Nurse practitioners have full practice authority in the Aloha State, and pediatric-primary care nurse practitioners play an important role in delivering healthcare to children throughout the islands. There are two children’s hospitals on Hawaii, and both are located in Honolulu. PNP-PCs average $56.55 an hour or $117,620 a year, while PNP-ACs average $51.44 an hour or $106,990 a year.

TypePNP-PCPNP-AC
Hourly$56.55$51.44
Annual$117,620$106,990


10. Oregon: In Oregon, 25 percent of the primary care provided in the state is delivered by nurse practitioners. Oregon is a full practice state for NPs, so pediatric-primary care nurse practitioners are free to fill in the gaps that exist in children’s access to primary care. The average salary for pediatric nurse practitioners in Oregon is $56.46 an hour or $117,440 a year for PNP-PCs, and $51.36 or $106,830 for PNP-ACs; this is 4 percent more than the national average. Oregon has four children’s hospitals.

TypePNP-PCPNP-AC
Hourly$56.46$51.36
Annual$117,440$106,830


11. Arizona: More than 9 percent of Arizona children are without healthcare insurance coverage, making it difficult for them to get access to the primary care services they need to grow into healthy adults. Fully 25 percent of children in the Grand Canyon State are overweight or obese, and 10 percent are affected by asthma. Arizona is a full practice state for NPs, so pediatric-primary care nurse practitioners have the potential to improve the health status of the kids who live here. There are two children’s hospitals in Arizona. The average salary for pediatric nurse practitioners in Arizona is $55.93 an hour or $116,330 for PNP-PCs, and $50.88 or $105,820 for PNP-ACs.

TypePNP-PCPNP-AC
Hourly$55.93$50.88
Annual$116,330$105,820


12. Rhode Island: In Rhode Island, pediatric-primary care nurse practitioners earn $55.84 an hour or $116,150 a year, while pediatric-acute care nurse practitioners earn $50.80 an hour or $105,660 a year. Both children’s hospitals are located in Providence, the tiny state’s largest city. The Ocean State is facing a 2 percent shortage in primary healthcare providers. Since NPs in Rhode Island have full practice authority, PNPs could be the solution to increasing primary care services to the state’s children.

TypePNP-PCPNP-AC
Hourly$55.84$50.80
Annual$116,150$105,660


13. New Mexico: Kids in New Mexico face serious health challenges including poverty and high obesity rates. The asthma prevalence among children is 7.6 percent, and the Asthma and Allergy Foundation of America recently dubbed Albuquerque the worst city in the western U.S. for asthma sufferers. The state is also looking at a potentially serious shortage of primary care providers in the near future, but as a full practice state for NPs, pediatric-primary care nurse practitioners have the ability to step into that gap. PNP-PCs in the Land of Enchantment earn $55.72 an hour or $115,900 annually on average, while PNP-ACs earn $50.69 an hour or $105,440 a year. New Mexico’s two children’s hospitals are both in Albuquerque.

TypePNP-PCPNP-AC
Hourly$55.72$50.69
Annual$115,900$105,440


14. Connecticut: Since only 20 percent of Connecticut’s physician workforce are primary care practitioners, nurse practitioners are stepping up to the plate to provide primary care services. NPs in Connecticut are allowed to practice independently after collaborating for three years with a physician, and stakeholders throughout the state are enthusiastic about nurse practitioners' increasingly important role. The average salary for pediatric nurse practitioners in Connecticut is $55.59 an hour or $115,530 annually for PNP-PCs, and $50.57 an hour or $105,190 for PNP-ACs. The Constitution State has two children’s hospitals.

TypePNP-PCPNP-AC
Hourly$55.59$50.57
Annual$115,630$105,190


15. Texas: The average pediatric nurse practitioner salary in Texas is $55.56 an hour or $115,530 a year for primary care specialists, and $50.57 an hour or $105,190 a year for acute care specialists. Pediatric nurse practitioner salaries in the Dallas/Fort Worth area are right in line with the state average while PNP salaries in the Houston area are 8 percent higher. Pediatric NP salaries in El Paso, on the other hand, are 3 percent lower.

The 639-bed Texas Children’s Hospital in Houston is the largest dedicated children’s medical center in the U.S. The hospital offers a fellowship program for PNPs who are interested in caring for children with cancer, hematologic disorders, and/or stem cell transplantation. There are 15 other children’s hospitals in the Lone Star State as well.

Nearly 13 percent of children in Texas lack healthcare insurance , which seriously compromises these children’s access to primary care. Texas children also have the 12th-highest rate of obesity in the nation, and 7 percent of the children who live in the Lone Star are affected by asthma.

TypePNP-PCPNP-AC
Hourly$55.56$50.54
Annual$115,560$105,120


16. Maryland: Pediatric nurse practitioners have been able to work independently in Maryland since 2015, thereby removing barriers that kept many children in rural and medically underserved areas from receiving high-quality primary healthcare. Maryland has four dedicated children’s hospitals, but children living in the greater District of Columbia metropolitan area also have access to D.C.’s two children’s hospitals. The average salary of a pediatric nurse practitioner in Maryland is only slightly more than the national average: PNP-PCs earn $54.86 an hour or $114,110 a year on average, and PNP-ACs earn $49.91 an hour or $103,810 a year.

TypePNP-PCPNP-AC
Hourly$54.86$49.91
Annual$114,110$103,810


17. Montana: Montana is facing a shortage of pediatric primary care providers: Thirty-eight rural counties are without pediatricians. Pediatric nurse practitioners are poised to step into that gap, however, because NPs can practice to the full extent of their training in the Big Sky State. PNP-PCs in Montana earn $54.45 an hour or $113,250 a year on average, and PNP-ACs earn $49.53 an hour or $103,020 a year; these salary statistics are in line with the average salary of pediatric nurse practitioners across the nation. Montana has one children’s hospital.

TypePNP-PCPNP-AC
Hourly$54.45$49.53
Annual$113,250$103,020


18. Idaho: Twenty-nine percent of Idaho’s children are obese, setting the stage for serious health issues such as diabetes, high blood pressure, and heart disease down the road. Idaho has been facing a serious physician shortage for more than a decade, but as a state that allows nurse practitioners full practice authority, PNPs may be able to provide the primary care services these children need. Pediatric-primary care nurse practitioners make $54.22 an hour or $112,770 annually in the Gem State on average; pediatric-acute care nurse practitioners make $49.32 an hour or $102,590 a year. Idaho’s sole children’s hospital is in Boise.

TypePNP-PCPNP-AC
Hourly$54.22$49.32
Annual$112,770$102,590


19. Utah: In Utah, PNP-PCs make $54.06 an hour or $112,440 a year on average, while PNP-ACs make $49.17 an hour or $102,280 a year. Both of the Beehive State’s children’s hospitals are located in Salt Lake City. Utah has a significant shortage of primary care practitioners. Pediatric nurse practitioners are poised to fill that gap but they face serious restrictions on their ability to prescribe the medications their pediatric patients may need.

TypePNP-PCPNP-AC
Hourly$54.06$49.17
Annual$112,440$102,280


20. Wisconsin: Like many midwestern states, Wisconsin is facing a shortage of primary healthcare providers that’s projected to worsen significantly over the next 10 years, particularly in the state’s more rural areas. At present, pediatric nurse practitioners can only practice in the Badger State under the terms of a collaborative agreement with a pediatrician or family practice physician; since these physicians are in short supply, PNPs may not be able to help bridge the primary healthcare gap. There are five children’s hospitals in Wisconsin, spread throughout the state. The average salary for pediatric nurse practitioners in Wisconsin is $53.81 an hour or $111,920 annually for PNP-PCs and $48.95 an hour or $101,810 for PNP-APs.

TypePNP-PCPNP-AC
Hourly$53.81$48.95
Annual$111,920$101,810


21. Oklahoma: Nearly 30 percent of Oklahoma’s children between the ages of 10 and 17 are overweight or obese, and 9.3 percent of kids in the Sooner State are affected by asthma. Though Oklahoma has a high percentage of primary care physicians, they are not evenly distributed throughout the state, leaving some children in rural areas without adequate access. Oklahoma has two children’s hospitals, one in Tulsa, and one in Oklahoma City. Pediatric-primary care nurse practitioners in Oklahoma earn $53.67 an hour or $111,640 on average, while pediatric-acute care nurse practitioners earn $48.83 an hour or $101,560 a year.

TypePNP-PCPNP-AC
Hourly$53.67$48.83
Annual$111,640$101,560


22. New Hampshire: New Hampshire was dubbed the best state in the nation so far as children’s health goes in a recent report from the Annie E. Casey Foundation. The Granite State got high marks on metrics like childhood obesity rates, asthma rates, and access to primary care. Pediatric nurse practitioners are able to play a significant role in the delivery of primary healthcare here because New Hampshire is a full practice state. Pediatric-primary care nurse practitioners average $53.54 an hour or $111,360 a year in New Hampshire, while pediatric-acute care nurse practitioners average $48.70 an hour or $101,300 a year.

TypePNP-PCPNP-AC
Hourly$53.54$48.70
Annual$111,360$101,300


23. Delaware: More than 1,000 nurse practitioners are employed in Delaware , and they play an important role in providing primary care to the state’s children and adolescents. Pediatric nurse practitioners can practice independently after they’ve worked collaboratively with a pediatrician or family care physician for two years. PNP-PCs average $53.43 an hour or $111,130 a year, while PNP-ACs average $48.60 or $101,090 a year. Delaware’s single children’s hospital is located in Wilmington.

TypePNP-PCPNP-AC
Hourly$53.43$48.60
Annual$111,130$101,090


24. Illinois: In 2019, more than 15 percent of Illinois kids were living in poverty , which put them at much higher risk for developing chronic health problems like obesity, diabetes, and hypertension when they become adults. Chicago kids have distressingly high rates of obesity, depression, and substance abuse. Illinois children in rural and medically underserved areas have insufficient access to primary care pediatricians. But since Illinois allows NPs to practice independently once they’ve acquired 500 hours of clinical practice under the supervision of a physician, pediatric nurse practitioners have the potential to fill the primary care gap. Illinois has 10 children’s hospitals; most of these are in the Chicago area.

The average salary of a pediatric nurse practitioner in Illinois is 2 percent less than the national average for all PNPs in the U.S. Pediatric-primary care nurse practitioners make $53.35 an hour or $110,960 a year on average, and pediatric-acute care nurse practitioners make $48.53 an hour or $100,940 a year. PNPs in Chicago, the state’s largest city, make marginally less than the average pediatric nurse practitioner salary throughout the state.

TypePNP-PCPNP-AC
Hourly$53.35$48.53
Annual$110,960$100,940


25. Louisiana: The average pediatric nurse practitioner salary in Louisiana is $53.26 an hour or $110,780 annually for PNP-PCs, and $48.45 an hour or $100,780 annually for PNP-ACs. Twenty-seven percent of the Bayou State’s children live in poverty, which makes it difficult for them to get access to the primary care services they need. The state is also facing a drastic shortage of primary care providers, particularly in rural areas and impoverished inner-city neighborhoods. Pediatric nurse practitioners have the training to mitigate this shortage, but they are hampered by Louisiana’s restrictive nurse practitioner stipulations.

TypePNP-PCPNP-AC
Hourly$53.26$48.45
Annual$110,780$100,780


26. Maine: In Maine, pediatric-primary care nurse practitioners take home $53.12 an hour or $110,490 a year on average while pediatric-acute care nurse practitioners take home $48.32 an hour or $100,510 a year. These salaries are 3 percent less than the national average for pediatric nurse practitioners. The Pine Tree State has one children’s hospital, located in the state’s most populous city, Portland.

TypePNP-PCPNP-AC
Hourly$53.12$48.32
Annual$110,490$100,510


27. Pennsylvania: Nearly 96 percent of Pennsylvania’s children are covered by some form of healthcare insurance, and well over 85 percent of kids in the Keystone State have regular access to primary care services . Nevertheless, Pennsylvania’s children still face significant health challenges, which pediatric-primary care nurse practitioners can help with. Nearly 30 % of children between the ages of 10 and 17 in the Keystone State are clinically overweight or obese. Additionally, 287,400 Pennsylvania children have been diagnosed with asthma.

Pennsylvania has seven children’s hospitals where many of the state’s pediatric-acute care nurse practitioners are employed. Those hospitals are mainly clustered around Philadelphia and Pittsburgh.

The average salary for pediatric nurse practitioners in Pennsylvania is $53.11 an hour or $110,470 annually for PNP-PCs, and $48.31 an hour or $100,490 annually for PNP-ACs; this is 3 percent less than the average salary for PNPs throughout all parts of the U.S. PNPs in Philadelphia, the state’s largest city, make 4 percent more than the state average.

TypePNP-PCPNP-AC
Hourly$53.11$48.31
Annual$110,470$100,490


28. North Dakota: North Dakota’s pediatric-primary care nurse practitioners earn $52.88 an hour and $109,980 annually on average while pediatric-acute care nurse practitioners earn $48.10 or $100,050 annually. North Dakota is a full practice state, which may be one of the reasons why—unlike many of its neighbors—the Peace Garden State isn’t facing a primary healthcare provider shortage. There is one children’s hospital in North Dakota , located in Fargo.

TypePNP-PCPNP-AC
Hourly$52.88$48.10
Annual$109,980$100,050


29. Alaska: Alaska is currently facing a serious shortage of primary care physicians, and that shortage is expected to grow more serious in the coming decade. Pediatric nurse practitioners can pick up the slack especially in rural areas because the Last Frontier was one of the first states to allow NPs to practice to the full extent of their training. In Alaska, PNP-PC’s average $52.50 an hour or $109,190 a year, while PNP-ACs average $47.75 an hour or $99,330 a year. Alaska’s sole children’s hospital is located in Anchorage.

TypePNP-PCPNP-AC
Hourly$52.50$47.75
Annual$109,190$99,330


30. Indiana: Thirty-seven percent of the Hoosier State’s youth between the ages of 10 and 17 are clinically obese, and 8.6 percent of the state’s kids are affected by asthma. Pediatric nurse practitioners could do more to offset pediatrician shortages if Indiana law allowed NPs to practice to the full extent of their training. Indiana has three children’s hospitals; two are in Indianapolis and one is in South Bend. The average salary for pediatric nurse practitioners in Indiana is $52.34 an hour or $108,860 annually for PNP-PCs, and $47.61 an hour or $99,030 annually for PNP-ACs.

TypePNP-PCPNP-AC
Hourly$52.34$47.61
Annual$108,860$99,030


31. Colorado: Overall, Colorado is one of the healthiest states in the nation for kids. But there’s a lot of regional variation. In more rural counties or the poorer city neighborhoods, childhood obesity is not uncommon, and 58,000 kids lack health insurance, which means they lack access to primary healthcare services. NPs in Colorado have full practice authority, so pediatric nurse practitioners there play a vital role in tackling the Centennial State’s pediatric health issues. There’s one children’s hospital in Aurora. On average, the salary of a pediatric NP in Colorado is $52.25 an hour or $108,680 for primary care specialists, and $47.53 an hour or $98,870 for acute care specialists.

TypePNP-PCPNP-AC
Hourly$52.25$47.53
Annual$108,680$98,870


32. Virginia: Virginia has six children’s hospitals, but Virginia PNP-ACs who live in the Washington D.C. suburbs are as likely to work in one of D.C.’s two children’s hospitals. The salary of a pediatric nurse practitioner in Virginia on average is $52.20 an hour or $108,580 annually for PNP-PCs, and $47.49 an hour or $98,780 annually for PNP-APs. Virginia is experiencing a primary healthcare provider shortage that manifests most starkly in its rural and medically underserved urban areas. Pediatric nurse practitioners in the Old Dominion State can only practice when they are supervised by physicians, so it’s difficult for them to fill in the gaps in the state’s pediatric primary healthcare system.

TypePNP-PCPNP-AC
Hourly$52.20$47.49
Annual$108,580$98,780


33. Mississippi: Mississippi is ranked as the worst state for healthcare in the U.S. for both adults and children. Twenty-eight percent of its children live in poverty, and 38 percent are overweight or obese. The state is facing a shortage of primary healthcare physicians, which impacts the effectiveness of pediatric nurse practitioners since they can’t practice in the Magnolia State without a pediatrician to supervise them. Mississippi PNP-PCs earn $52.15 an hour or $108,480 annually on average, while PNP-ACs earn $47.44 an hour or $98,680 a year. Mississippi’s single children’s hospital is in Jackson.

TypePNP-PCPNP-AC
Hourly$52.15$47.44
Annual$108,480$98,680


34. Michigan: Michigan has a significant shortage of primary healthcare providers. The need for better pediatric primary care in the Wolverine State is highlighted by its high obesity rates among children aged 10 to 17 (30 percent) and a juvenile asthma prevalence of 10.7 percent. Michigan law stipulates that NPs can only work under the supervision of a physician; that means that in rural and underserved parts of the state where supervising pediatricians are not available, pediatric nurse practitioners cannot step in. The average pediatric nurse practitioner salary in Michigan is $51.96 an hour or $108,080 for PNP-PCs, and $47.27 an hour or $98,320 for PNP-ACs. Michigan has six children’s hospitals evenly distributed throughout the state.

TypePNP-PCPNP-AC
Hourly$51.96$47.27
Annual$108,080$98,320


35. North Carolina: North Carolina has been ranked as one of the 10 worst states in the nation in terms of children’s access to primary healthcare. While the Tar Heel State has many pediatricians, they tend to congregate around academic health centers or around major hospitals in metropolitan areas, leaving many rural and inner-city areas underserved. Though primary care nurse practitioners in North Carolina can and do run their own solo practices, they can only do so under the terms of contracts with collaborating physicians. In medically under-served areas where no pediatrician is available to supervise them, pediatric-primary care nurse practitioners can’t operate in North Carolina.

The average salary of a pediatric nurse practitioner in North Carolina is $51.59 an hour or $107,310 annually for PNP-PCs, and $46.93 an hour or $97,620 for PNP-ACs. This amount is 5 percent less than the average pediatric nurse practitioner salary throughout all parts of the U.S. This salary statistic is in line with what PNPs earn in Charlotte, the largest city in the state, but 3 percent lower than what PNPs earn in Raleigh. There are eight dedicated pediatric hospitals in the Tar Heel State, most of which are located in the greater Charlotte metropolitan area.

TypePNP-PCPNP-AC
Hourly$51.59$46.93
Annual$107,310$97,620


36. Vermont: The American Academy of Pediatrics touts Vermont as the healthiest state, in no small part because of the ready availability of primary healthcare providers. Vermont is a full practice state for nurse practitioners, so pediatric nurse practitioners can work where they’re needed. Vermont’s sole children’s hospital is located in Burlington, its most populous city. Pediatric-primary care nurse practitioners in Vermont make $51.55 an hour or $107,220 a year on average, while pediatric-acute care nurse practitioners make $46.89 an hour or $97,540 a year.

TypePNP-PCPNP-AC
Hourly$51.55$46.89
Annual$107,220$97,540


37. Iowa: More than one-third of Iowa’s youth are clinically overweight or obese. Primary care interventions such as those provided by pediatric nurse practitioners can play an important role in addressing this issue. Iowa has four dedicated children’s hospitals. Pediatric-primary care nurse practitioners in Iowa make $51.37 an hour or $106,850 a year on average, while pediatric-acute care nurse practitioners make $46.73 an hour or $97,200 a year. Pediatric NP salaries in Iowa are 6 percent less than the national average.

TypePNP-PCPNP-AC
Hourly$51.37$46.73
Annual$106,850$97,200


38. Nebraska: Nebraska’s 1,335 nurse practitioners fill an important role in filling the gaps left by the shortage of primary care providers throughout the state. Since Nebraska is a full practice state, pediatric nurse practitioners are able to step into rural and medically underserved areas to provide the primary healthcare Nebraska’s children need. Pediatric-primary care nurse practitioners average $51.10 an hour or $106,280 annually in the Cornhusker State, while pediatric-acute care nurse practitioners average $46.48 an hour or $96,680 annually.

TypePNP-PCPNP-AC
Hourly$51.10$46.48
Annual$106,280$96,680


39. Missouri: Pediatric nurse practitioner salary in Missouri differs for primary care and acute care specialists: Pediatric-primary care nurse practitioners earn $50.88 an hour or $105,820 a year across the state on average, while pediatric-acute care nurse practitioners earn $46.28 an hour or $96,270 a year. But in St. Louis, in the eastern part of the state, PNPs earn $96,872 a year, which is 8 percent less than the state average, while in Kansas City, on the western border, PNPs earn $109,560, which is 4 percent more.

Eight percent of Missouri children under the age of 17 have been diagnosed with asthma. More than 16 percent of Missouri youth between the ages of 10 and 17 meet the clinical parameters for obesity. Youth in the Show Me State are also facing a pediatric mental health crisis, exacerbated by the COVID-19 crisis: Missouri’s eight children’s hospitals reported a 31 percent increase in pediatric emergency room visits related to suicide ideation, self-injury, and substance abuse disorders in 2020.

TypePNP-PCPNP-AC
Hourly$50.88$46.28
Annual$105,820$96,270


40. Georgia: Georgia was ranked lowest in the nation for children’s healthcare by WalletHub. The financial website used parameters like access to primary healthcare, obesity rates, and asthma rates to make its determination. Nearly 15 percent of youth in the Peach State are clinically obese; nearly 9 percent of Georgia’s children have been diagnosed with asthma, and pediatricians suspect many more children remain undiagnosed due to poor access to primary healthcare.

PNPs in the Peach State average 7 percent less than PNPs throughout the nation as a whole average. The average salary for pediatric nurse practitioners in Georgia is $50.57 an hour or $105,180 a year for pediatric-primary care nurse practitioners, and $46 an hour or $95,680 a year for pediatric-acute care nurse practitioners. PNPs in Atlanta earn salaries that are 1 percent higher than the state average for PNPs. Two of Georgia’s four children’s hospitals are located in Atlanta; the others are in Augusta and Brunswick.

TypePNP-PCPNP-AC
Hourly$50.57$46.00
Annual$105,180$95,680


41. Arkansas: The 2021 Childhood Report published by the international nonprofit “Save the Children” called Arkansas the worst state in the nation in terms of helping children and their parents cope with the COVID-19 pandemic. The Natural State is facing a serious shortage of primary care pediatricians, particularly in rural areas. Since PNP-PCs don’t have full practice authority, it’s hard for them to take up the slack. Arkansas pediatric-primary care nurse practitioners make $50.56 an hour or $105,170 a year on average, while pediatric-acute care practitioners make $46 an hour or $95,670 a year.

TypePNP-PCPNP-AC
Hourly$50.56$46.00
Annual$105,170$95,670


42. Ohio: Pediatric health in Ohio is consistently classed in the bottom half of U.S. rankings. Ohio’s child health challenges include asthma and obesity: 7.8 percent of children in Ohio have been diagnosed with asthma, and 15.7 percent of Ohio kids between the ages of 10 and 17 are obese. The Buckeye State is facing a serious shortage of primary healthcare providers, but restrictions on NPs’ ability to practice to the full extent of their education mean that Ohio’s pediatric nurse practitioners have a difficult time filling children’s healthcare access gap.

The average pediatric nurse practitioner salary in Ohio is $50.28 an hour or $104,590 annually for PNP-PCs, and $45.75 an hour or $95,150 annually for PNP-ACs. The Buckeye State has nine children’s hospitals. Three of those medical centers are in Cleveland where pediatric nurse practitioner salaries are pretty much on a par with the state average. The others are spread throughout Columbus, Cincinnati, Toledo, Akron, and Dayton where PNP salaries are 2 percent lower than the state average.

TypePNP-PCPNP-AC
Hourly$50.28$45.75
Annual$104,590$95,150


43. West Virginia: Nearly 20 percent of West Virginia’s kids live in poverty. Primary healthcare provider shortages are endemic in the rural areas that comprise the greater part of the state. Primary care nurse practitioners with the equivalent of five years of full-time practice can be certified independently, so pediatric-primary care nurse practitioners have the potential to provide services to the West Virginia children who need them. PNP-PCs in the Mountain State earn $50.09 an hour or $104,190 a year on average, while PNP-ACs earn $45.57 an hour or $94,780 a year. The state has two children’s hospitals .

TypePNP-PCPNP-AC
Hourly$50.09$45.57
Annual$104,190$94,780


44. Kansas: Kansas’s childhood obesity rate (10.6 percent) is considerably lower than the national average, which argues well for the effectiveness of the state’s pediatric primary healthcare networks. The state has no dedicated children’s hospitals. Pediatric-acute care nurse practitioners in the Sunflower State make $45.27 an hour or $94,160 a year on average, while pediatric-primary care nurse practitioners make $49.76 an hour or $103,500 a year. This amount is 9 percent less than the national average.

TypePNP-PCPNP-AC
Hourly$49.76$45.27
Annual$103,500$94,160


45. South Dakota: South Dakota has a single children’s hospital, located in Sioux Falls. Pediatric-acute care nurse practitioners who typically work in medical centers average $44.54 an hour or $92,850 a year in the Mount Rushmore State, while pediatric-primary care nurse practitioners make $49.07 an hour or $102,070 a year. On WalletHub’s 2021 analysis of the best and worst states for children’s healthcare, South Dakota is in the middle of the pack.

TypePNP-PCPNP-AC
Hourly$49.07$44.64
Annual$102,070$92,850


46. Kentucky: The average pediatric nurse practitioner salary in Kentucky is $48.78 an hour or $101,460 annually for PNP-PCs and $44.37 an hour or $92,290 for PNP-ACs. In the state’s largest city Louisville, however, salaries are 3 percent higher. Kentucky has the highest incidence of childhood obesity in the nation. The state has two children’s hospitals.

TypePNP-PCPNP-AC
Hourly$48.78$44.37
Annual$101,460$92,290


47. South Carolina: The average salary for pediatric nurse practitioners in South Carolina is 12 percent less than the national average. PNP-PCs make $48.17 an hour or $100,200 a year on average, while PNP-ACs make $43.82 an hour or $91,150 a year. According to the state’s Department of Health and Environmental Control, every county in South Carolina has been designated a medically underserved area, at least in part, and this has a negative impact on the health of the state’s children. South Carolina has two children’s hospitals: one in Charleston and one in Greenville.

TypePNP-PCPNP-AC
Hourly$48.17$43.82
Annual$100,200$91,150


48. Florida: The lowest-paid pediatric nurse practitioners in the 50 major American metropolitan centers work in Miami, Florida. Miami’s PNPs make 4 percent less than the average pediatric nurse practitioner salary in Florida—which is $48.11 an hour or $100,070 on average for pediatric-primary care nurse practitioners, and $43.76 an hour or $91,030 for pediatric-acute care nurse practitioners. Why is the average pediatric nurse practitioner salary in Florida so low? Probably because employers know that Florida is considered such an attractive place to live that those employers will always have numerous applicants for any job vacancy, no matter how little they pay.

Florida has the second-largest number of children without healthcare coverage in the nation; in 2019, that count was an estimated 325,000 children. Many of those children are members of immigrant families that have been in the U.S. for less than five years. Amid the surge in the delta variant of COVID-19, admissions to the Sunshine State’s 14 dedicated children’s hospitals are soaring.

TypePNP-PCPNP-AC
Hourly$48.11$43.76
Annual$100,070$91,030


49. Alabama: The average pediatric nurse practitioner salary in Alabama is $47.50 an hour or $98,810 annually for PNP-PCs and $43.22 an hour or $89,890 annually for PNP-ACs. This amount is 13 percent less than the average pediatric nurse practitioner salary in all parts of the U.S. The Yellowhammer State gets poor marks overall on health indicators for children like rates of obesity and asthma. There are two children’s hospitals in Alabama.

TypePNP-PCPNP-AC
Hourly$47.50$43.22
Annual$98,810$89,890


50. Tennessee: Tennessee is the worst state in the nation when it comes to pediatric nurse practitioner salaries. PNP-PCs in the Volunteer State make $47.31 an hour or $98,400 annually on average, while PNP-ACs make $43.03 an hour or $89,510 annually. Pediatric nurse practitioners working in Nashville make 1 percent less than the state average, while pediatric nurse practitioners working in Memphis make 10 percent more.

One reason why pediatric nurse practitioner salary in Tennessee may be so low is because the state did not expand access to Medicaid funding as permitted under the terms of the Affordable Care Act. This affects the amount of money available to fund vital primary healthcare services, which, in turn, affects access to care. Tennessee has seven children’s hospitals.

TypePNP-PCPNP-AC
Hourly$47.31$43.03
Annual$98,400$89,510




Average Pediatric Nurse Practitioner Salary In 50 Major U.S. Cities


When you’re looking at the average salary of a pediatric nurse practitioner in 2021, location matters. The highest-paid pediatric nurse practitioners are those who work in California’s San Francisco Bay area where the average pediatric nurse practitioner salary is $176,060 for PNP-PCs and $160,160 for PNP-ACs. This amount is 55 percent more than the average pediatric nurse practitioner salary throughout all parts of the U.S and 83 percent more than the PNPs would earn working in Miami.

Miami and Tampa are the cities where pediatric nurse practitioners earn the least amount of money. This likely has to do with the fact that Florida with its sunny weather and lack of state income tax is considered a highly desirable place to live. Workplaces here do not have to use salary incentives to attract PNPs because so many pediatric nurse practitioners may be actively seeking jobs that will allow them to remain in the Sunshine State.

City PNP-PC PNP-AC
Per Hour Per Year Per Hour Per Year
Albuquerque, NM $51.88 $107,920 $47.20 $98,180
Arlington, TX $55.58 $115,600 $50.56 $105,160
Atlanta, GA $50.98 $106,040 $46.38 $96,460
Austin, TX $53.12 $110,490 $48.32 $100,510
Baltimore, MD $55.49 $115,410 $50.48 $104,990
Boston, MA $60.43 $125,690 $54.97 $114,340
Charlotte, NC $51.55 $107,220 $46.89 $97,540
Chicago, IL $53.32 $110,910 $48.51 $100,900
Colorado Springs, CO $48.46 $100,790 $44.08 $91,690
Columbus, OH $49.39 $102,730 $44.93 $93,460
Dallas, TX $55.58 $115,600 $50.56 $105,160
Denver, CO $53.60 $111,490 $48.76 $101,420
Detroit, MI $53.06 $110,370 $48.27 $100,400
El Paso, TX $53.68 $111,650 $48.83 $101,570
Fort Worth, TX $55.58 $115,600 $50.56 $105,160
Fresno, CA $65.43 $136,090 $59.52 $123,800
Houston, TX $59.89 $124,580 $54.49 $113,330
Indianapolis, IN $52.39 $108,970 $47.66 $99,130
Jacksonville, FL $48.95 $101,810 $44.53 $92,620
Kansas City, MO $52.67 $109,560 $47.92 $99,670
Las Vegas, NV $55.00 $114,390 $50.03 $104,060
Long Beach, CA $67.97 $141,370 $61.83 $128,600
Los Angeles, CA $67.97 $141,370 $61.83 $128,600
Louisville, KY $50.38 $104,800 $45.84 $95,340
Memphis, TN $52.10 $108,370 $47.39 $98,580
Mesa, AZ $55.38 $115,190 $50.38 $104,790
Miami, FL $46.19 $96,080 $42.02 $87,400
Milwaukee, WI $53.27 $110,810 $48.47 $100,810
Minneapolis, MN $57.13 $118,820 $51.97 $108,090
Nashville, TN $46.93 $97,620 $42.70 $88,810
New Orleans, LA $53.77 $111,840 $48.91 $101,740
New York, NY $63.50 $132,070 $57.76 $120,150
Oakland, CA $84.64 $176,060 $77.00 $160,160
Oklahoma City, OK $54.05 $112,420 $49.17 $102,270
Omaha, NE $51.76 $107,660 $47.09 $97,940
Philadelphia, PA $56.58 $117,690 $51.48 $107,070
Phoenix, AZ $55.38 $115,190 $50.38 $104,790
Portland, OR $56.33 $117,170 $51.25 $106,590
Raleigh, NC $52.97 $110,170 $48.18 $100,220
Sacramento, CA $70.53 $146,700 $64.16 $133,450
San Antonio, TX $52.63 $109,480 $47.88 $99,590
San Diego, CA $60.04 $124,880 $54.62 $113,610
San Francisco, CA $84.64 $176,060 $77.00 $160,160
San Jose, CA $72.95 $151,740 $66.37 $138,040
Seattle, WA $61.39 $127,700 $55.85 $116,160
Tampa, FL $47.01 $97,780 $42.76 $88,950
Tucson, AZ $57.49 $119,580 $52.30 $108,780
Tulsa, OK $54.69 $113,760 $49.75 $103,490
Virginia Beach, VA $49.37 $102,690 $44.91 $93,420
Washington, DC $56.61 $117,750 $51.50 $107,120


What Is The 10-Year Outlook Like For Pediatric Nurse Practitioner Salary?


Pediatric nurse practitioners are likely to see pediatric nurse practitioner salary rise within the next decade: The demand for their services is extremely high, but there’s a critical shortage of PNPs. In labor markets where a profession is in short supply but in high demand, wages typically skyrocket.

Data from the 2017 National Nurse Practitioner Sample Survey shows that the supply of PNPs graduating from training programs has not kept up with the supply of other types of nurse practitioners. Of course, to some degree, family nurse practitioners can act as effective substitutes for pediatric nurse practitioners. There are significant differences in how FNPs and PNPs are trained, however, and most FNPs report that they deal mostly with older children and teens. Pediatric nurse practitioners can deal with children of all ages, from newborns to adolescents near young adulthood.

Within acute care settings, administrators and pediatric specialists have indicated a commitment to expanding the scope of PNP-AC practice. And in the realm of primary care, PNP-PCs are effective substitutes for pediatricians. Millions of children living in rural and medically underserved areas lack access to primary care services because the number of pediatricians has declined precipitously over the past decade. Pediatric nurse practitioners provide an obvious solution to this challenge, and pediatric nurse practitioner salary increases are a sure-fire way to attract more advanced practice nurses into this profession.


5 Ways Pediatric Nurse Practitioners Can Increase Their Earning Potential


Looking for ways to boost your take-home pay as a pediatric nurse practitioner? Here are some options to think about:

1. Seek out additional certifications: Pediatric-acute care nurse practitioners have a straightforward avenue toward earning a higher pediatric nurse practitioner salary: They can pursue a primary care certification. They can also pursue additional certifications within specialty areas associated with their acute care specialization such oncology, cardiology, or neurology.

2. Become a preceptor: Some graduate nursing programs pay nurses to precept their students. Traditionally, NP preceptors offered their services for free. But recently, as it’s become harder and harder to find preceptors, some graduate nursing programs have been paying preceptors for their services. Some schools will pay between $100 and $450 a week for precepting services.

3. Take a teaching position: If there’s a nursing program at a community college close to you, find out whether they might be searching for an adjunct instructor. Nearby hospitals may also be glad to engage you to lead clinical in-services for staff members.

4. Go back to school: If you have an MSN, think about returning to graduate school to pursue a DNP. The National Organization of Nurse Practitioner Faculties is leading the push to make DNPs the educational minimum for all advanced practice nurses by 2025, so this will give you a jump start. Besides, evidence exists that suggests advanced practice nurses with DNP degrees earn $7,000 more each year on average than advanced practice nurses with MSN degrees.

5. Move to another state: As we have seen, there’s a huge range from state to state in the salary paid to pediatric nurse practitioners. If you live in a state where PNPs aren’t remunerated highly, you always have the option of moving to a state where the pay is better.


Summing It Up


This article has offered a deep dive into the question: “How much does a pediatric nurse practitioner make?” Pediatric nurse practitioners make comfortable salaries for the most part, but the average salary of a pediatric nurse practitioner in 2021 should only be one of several factors when you’re choosing an NP specialty.

Working with kids is a special skill that requires patience, compassion, empathy, and great communication skills. Compared with adults, children require a great deal of additional support from their caregivers, and if you’re not prepared to give that, pediatric nurse practice may not be the career path for you. If you love kids, though, becoming a PNP can be a highly rewarding career because helping children means investing in the future.


TOP QUESTIONS ANSWERED BY OUR EXPERT


1. How many hours a week do Pediatric Nurse Practitioners work?

Practice settings determine the number of hours pediatric nurse practitioners work in any given week. Hospital-based PNPs will typically work 36 hours a week (three 12-hour shifts) while clinic-based PNPs will work closer to 40 hours a week.


2. What types of Pediatric Nurse Practitioners get paid the most?

Pediatric-primary care nurse practitioners get paid approximately 10 percent more than pediatric-acute care nurse practitioners.


3. In which settings do Pediatric Nurse Practitioners get paid the most?

Pediatric nurse practitioners who are independent contractors or who operate their own solo practices earn the most money.


4. How does the salary of a Pediatric Nurse Practitioner compare to the Nurse Practitioner salary in the U.S?

Pediatric-primary care nurse practitioners earn salaries that are 4 percent higher than the salaries earned by nurse practitioners in the U.S. as a whole on average, while pediatric-acute care nurse practitioners earn salaries that are 6 percent less.

Level of Experience PNP-PC PNP-AC Nurse Practitioner PNP-PC PNP-AC
Number % Number %
Starting (Entry-Level) $82,150 $74,730 $78,990 +$3,160 +3.85% -$4,260 -5.70%
1-4 Years of Experience $93,960 $85,470 $90,340 +$3,620 +3.85% -$4,870 -5.70%
5-9 Years of Experience $110,580 $100,600 $106,330 +$4,250 +3.84% -$5,730 -5.70%
10-19 Years of Experience $128,960 $117,320 $124,000 +$4,960 +3.85% -$6,680 -5.69%
20 Years or More Experience $154,630 $140,670 $148,680 +$5,950 +3.85% -$8,010 -5.69%
Average Salary $113,387 $103,148 $109,025 +$4,362 +3.85% -$5,877 -5.70%

5. What are the 10 highest and lowest paying States for Pediatric Nurse Practitioners?

The highest-paid pediatric nurse practitioners work in California, New Jersey, Washington, New York, Massachusetts, Nevada, Minnesota, Wyoming, Hawaii, and Oregon.

The lowest-paid pediatric nurse practitioners work in Tennessee, Alabama, Florida, South Carolina, Kentucky, South Dakota, Kansas, West Virginia, and Ohio.

Rank Highest Paying States Lowest Paying States
State PNP-PC Salary PNP-AC Salary State PNP-PC Salary PNP-AC Salary
1 California $144,540 $131,490 Tennessee $98,400 $89,510
2 New Jersey $129,610 $117,900 Alabama $98,810 $89,890
3 Washington $125,240 $113,930 Florida $100,070 $91,030
4 New York $125,200 $113,890 South Carolina $100,200 $91,150
5 Massachusetts $124,810 $113,540 Kentucky $101,460 $92,290
6 Nevada $118,710 $107,990 South Dakota $102,070 $92,850
7 Minnesota $117,730 $107,100 Kansas $103,500 $94,160
8 Wyoming $117,640 $107,020 West Virginia $104,190 $94,780
9 Hawaii $117,620 $106,990 Ohio $104,590 $95,150
10 Oregon $117,440 $106,830 Arkansas $105,170 $95,670

6. Which State in the Nation pays the highest average annual salary for Pediatric Nurse Practitioners?

The highest-paid pediatric nurse practitioners in the U.S. are employed in the state of California. Pediatric-primary care nurse practitioners earn $144,540 annually on average in the Golden State; pediatric-acute care nurse practitioners earn $131,490.

California PNP-PC PNP-AC
$144,540 $131,490

7. Which State in the Northeast pays the most for Pediatric NPs?

In the Northeast, New Jersey is the state where pediatric nurse practitioners earn the highest salaries. PNP-PCs in the Garden State earn $129,610 a year on average, while PNP-ACs earn $117,900 a year.

New Jersey PNP-PC PNP-AC
$129,610 $117,900

8. Which State in the Midwest pays the most for Pediatric NPs?

In Minnesota, pediatric-primary care nurse practitioners earn $117,730 a year on average, and pediatric-acute care nurse practitioners earn $107,100 a year. Among the Midwestern states, Minnesota is the one that pays pediatric nurse practitioners the highest salaries.

Minnesota PNP-PC PNP-AC
$117,730 $107,100

9. Which State in the Southeast pays the most for Pediatric NPs?

In the Southeast, Louisiana PNPs earn the highest salaries. The average yearly salary for PNP-PCs is $110,780 on average, while the average yearly salary for PNP-ACs is $100,780.

Louisiana PNP-PC PNP-AC
$110,780 $100,780

10. Which State in the Southwest pays the most for Pediatric NPs?

Arizona PNP-PCs earn $116,330 annually on average, while Arizona PNP-ACs earn $105,820, making the Grand Canyon State the top Southwestern state for pediatric nurse practitioner salaries.

Arizona PNP-PC PNP-AC
$116,330 $105,820

11. Which State in the Western region pays the most for Pediatric NPs?

California is the top-paying state in the West for pediatric nurse practitioners. Pediatric-primary care nurse practitioners average $144,540 annually in the Golden State, and pediatric-acute care nurse practitioners average $131,490 annually.

California PNP-PC PNP-AC
$144,540 $131,490

12. Among the 50 Largest Cities in the Nation, what are the 10 highest and lowest paying cities for Pediatric NPs?

The major cities where pediatric nurse practitioners earn the highest salaries are 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.

The major cities where pediatric nurse practitioners earn the lowest salaries are Miami, FL; Nashville, TN; Tampa, FL; Colorado Springs, CO; Jacksonville, FL; Virginia Beach, VA; Columbus, OH; Louisville, KY; Atlanta, GA; and Charlotte, NC.

Rank Highest Paying Cities Lowest Paying Cities
City PNP-PC Salary PNP-AC Salary City PNP-PC Salary PNP-AC Salary
1 Oakland, CA $176,060 $160,160 Miami, FL $96,080 $87,400
2 San Francisco, CA $176,060 $160,160 Nashville, TN $97,620 $88,810
3 San Jose, CA $151,740 $138,040 Tampa, FL $97,780 $88,950
4 Sacramento, CA $146,700 $133,450 Colorado Springs, CO $100,790 $91,690
5 Long Beach, CA $141,370 $128,600 Jacksonville, FL $101,810 $92,620
6 Los Angeles, CA $141,370 $128,600 Virginia Beach, VA $102,690 $93,420
7 Fresno, CA $136,090 $123,800 Columbus, OH $102,730 $93,460
8 New York, NY $132,070 $120,150 Louisville, KY $104,800 $95,340
9 Seattle, WA $127,700 $116,160 Atlanta, GA $106,040 $96,460
10 Boston, MA $125,690 $114,340 Charlotte, NC $107,220 $97,540

13. Is the investment of time and money associated with becoming a Pediatric Nurse Practitioner worth it financially?

Pediatric-primary care nurse practitioners have the potential to earn high salaries, particularly if they become independent contractors or open up solo practices. While pediatric-acute care nurse practitioners earn somewhat less, their salaries are quite comfortable. Becoming a pediatric nurse practitioner will allow you to earn a good return on any investment you make in your education.


Sources

We have used the following sources to compile the salary data on this page.

1. Ziprecruiter.com
2. Payscale.com
3. U.S. Bureau of Labor Statistics
4. NP Editorial Assessment