CNM · North Dakota

Collaborative Practice Agreement for Certified Nurse-Midwives in North Dakota

No. Certified Nurse-Midwives practice independently here. North Dakota does not require one.

Practice authorityIndependent practice
Written agreementNo agreement required
What North Dakota calls itNo instrument required
Research date2026-09-03

CNM is one of ND's four APRN roles (NDAC § 54-05-03.1-02), licensed through the RN-to-APRN pathway (§ 54-05-03.1-04) rather than a separate midwifery act. No CNM-specific supervision, collaboration-agreement, or physician-oversight provision was found.

What the collaboration must look like

The rules the physician relationship has to follow. Each fact comes from the statute or board rule listed under sources.

Proximity

Not codified — left to the agreement

Supervision ratio

Not codified — no cap on file

Chart review

Not codified — left to the agreement

Meeting cadence

Not codified — left to the agreement

Prescriptive authority

Covered by the practice agreement · controlled substances permitted

Same general APRN prescribing regime as other APRN roles — no midwifery-specific carve-out (e.g. no separate obstetric-medication scope rule) found.

Written agreement

Not required

Unconditional — same as other APRN roles.

Practice ownership (corporate practice of medicine)

Licensee-only ownership required — Same as the general `np` entry — no CNM-specific ownership statute.

Legal sources for these rules (2)
  • N.D. Admin. Code § 54-05-03.1-02 — APRN roles
  • N.D. Admin. Code § 54-05-03.1-04 — RN-to-APRN licensure pathway (CNM role)

What a collaborating physician costs here

Typical monthly cost in North Dakota

$500$600

Estimate for one Certified Nurse-Midwife. Standard-tier state.

About North Dakota's rules

H.B. 1175 (2019, eff. 2020) and a 2022 rule amendment repealed ND's old PA supervision-contract/ratio/countersignature model — PAs are now CONDITIONAL only below 4,000 practice hours or outside a qualifying facility. All four APRN roles (NP, CRNA, CNM, CNS) are FULL independent practice with no collaboration agreement of any kind.

Other clinicians in North Dakota: see the state overview.