Can U.S. Certified Nurse Practitioners Practice in Canada?

I grew up in Washington State just a few hours away from the Canadian border. When I was in high school, my friends and I would pile into my mom’s van and drive to Whistler for a quick ski weekend. Back then, not even a passport was required to cross the border. A smiling border control agent would simply inquire as to the contents of our vehicle and let us pass by without so much as a second glance.

Times have changed and border crossings have become more difficult in recent years. Although our Northern neighbor may be reached in many cases in a matter of minutes, relocating to Canada to practice as a nurse practitioner isn’t easy. NPs certified in the United States may live and practice in Canada but in order to do so must follow an arduous stepwise process.

The process of becoming a nurse practitioner in Canada for those already certified in the U.S. varies by province, but in general the steps are as follows:

1. Understand the overall process and terminology

If you are a nurse practitioner educated and certified in the United States, when it comes to applying for a license in Canada, you are considered an Internationally Educated Nurse (IEN).

Review the steps of applying for nurse practitioner licensing closely before beginning the process to avoid making mistakes or doing unnecessary work. 

Most importantly, before beginning your application and licensure process, make sure you are eligible to work and live in Canada. Also, review the requirements to practice as a nurse practitioner where you plan to live. Some provinces, for example, require a specific number of hours nursing experience prior to licensure. If you don’t have the required experience, you may need to wait before applying. 

Similar to the system in the U.S., nurse practitioners looking to practice in Canada must first have their registered nursing licensure in order. To become a registered nurse in Canada, you will need to obtain a Canadian RN license. This process varies somewhat by province.

2. Apply to the NNAS

To become an RN in Canada, for many provinces the initial step is to apply through the National Nursing Assessment Service (NNAS). This organization regulates licensing of IEN’s. The organization will check your licensing, credentials, and verify education. The process costs about $650 and can take up to 12 months. An online handbook outlining the process in detail can be found here.

3. Apply to the appropriate provincial regulatory body

The next step in becoming a registered nurse in Canada is to apply with the nursing regulatory body in the province where you plan to practice. For example, in Alberta, you must apply for a nursing license through the College and Association of Registered Nurses of Alberta (CARNA). In Saskatchewan, nurses must apply for Canadian licensure with the Saskatchewan RN Association (SRNA).

The provincial regulatory body will review your application deciding if you are qualified to proceed in the nursing licensure process. In some cases, additional training or testing may be required. Most provinces recognize NCLEX scores dating back more than 30 years, so most U.S. registered nurses should not be required to repeat testing.

Note: Canada formerly used the Canadian Registered Nurse Exam (CRNE) as the test of preference for nurses. On January 1, 2015, at least 10 provinces will transition to recognizing the NCLEX as the exam of preference.

4. Finalize RN registration in the province where you wish to practice

Once the nursing regulatory body for the province where you plan to practice has reviewed your application, complete any additional necessary paperwork, take the NCLEX if necessary, and pay any fees required to officially obtain your RN license.

Note: Many provinces refer to “RN registration” rather than the U.S. term “RN licensure”.

5. Review nurse practitioner licensing requirements for your province

Requirements to practice as a nurse practitioner vary from province to province. Some provinces such as Saskatchewan require that RNs have nursing experience prior to advancing their practice. Other provinces, for example, recognize the U.S.-based ANCC certification exam while some prefer the AANP. In many cases you may be able to avoid re-taking the nurse practitioner certification exam if results from your U.S. certifying body are recognized by your province of interest. You may need to contact the board of nursing directly to discuss your individual situation in order to identify any additional qualifications or experience required to become a licensed nurse practitioner in your specific province.

Complete any necessary courses, hours of experience, or testing you need to apply for nurse practitioner licensure in your province.

6. Apply for nurse practitioner licensure

Submit your application for nurse practitioner licensure to the appropriate board of nursing for your province. Pay any necessary fees as well.

7. Obtain the appropriate documentation to live and work in Canada 

If you are a Canadian citizen, having your U.S. certification, licensure and education validated is the only hurdle you need to overcome in order to begin practicing as a nurse practitioner in Canada. If you are a U.S. citizen, you must obtain the appropriate visa and work permit to reside and practice in the country. This involves submitting proof of identity and may require you to secure employment before submitting your application. Make sure you will be eligible to live and work in Canada before beginning the Canadian nurse practitioner certification process.


Have you completed the nurse practitioner licensure process in Canada? Do you have any tips for NPs certified in the United States making the transition to practicing in Canada?


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