CNS · North Dakota
Collaborative Practice Agreement for Clinical Nurse Specialists in North Dakota
No. Clinical Nurse Specialists practice independently here. North Dakota does not require one.
Unlike some states, North Dakota maintains CNS as a distinct, long-standing codified APRN role (NDAC § 54-05-03.1-02) rather than folding it into NP. No CNS-specific supervision, collaboration-agreement, or physician-oversight provision was found — same full-authority framework as the other three APRN roles.
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 (NDAC §§ 54-05-03.1-09 to -11) as other APRN roles.
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 CNS-specific ownership statute.
Legal sources for these rules (2)
- N.D. Admin. Code § 54-05-03.1-02 — APRN roles
- N.D. Admin. Code § 54-05-03.1-01 — Statement of intent (CNS licensure history)
What a collaborating physician costs here
Typical monthly cost in North Dakota
$500 – $600
Estimate for one Clinical Nurse Specialist. 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H.B. 1175 (2019, eff. 2020) and a 2022 rule amendment repealed ND's old PA supervision-contract/ratio/countersignature model — PAs are now CONDITIONAL only below 4,000 practice hours or outside a qualifying facility.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.