The 5 States With the Most Need for Nurse Practitioners

Last Updated/Verified: Aug 22, 2025
Map of USA with stethoscope

Nurse Practitioners (NPs) play a vital role in the healthcare system, providing high-quality patient care, especially in underserved areas. As the demand for healthcare services continues to grow, certain states across the United States face a pressing need for more NPs to bridge the healthcare gap. In this article, we’ll explore the top five states with the highest need for NPs and the factors contributing to this demand.

1. Tennessee

Tennessee ranks first on the list of states with the highest need for Nurse Practitioners. The Volunteer State is grappling with healthcare disparities in both urban and rural areas. Factors contributing to this demand include a growing aging population, high rates of chronic diseases, and limited access to healthcare services in rural communities. According to the Bureau of Labor Statistics, out of every 1,000 jobs in Tennessee, 4.18 are nurse practitioner positions. NPs in Tennessee play a crucial role in delivering primary care services, especially in medically underserved regions.

2. Mississippi

Mississippi, often cited for its healthcare challenges, takes the second spot on our list. The state faces significant health disparities, including high rates of obesity, diabetes, and cardiovascular disease. According to the BLS, 3.54 out of 1,000 open job positions are nurse practitioner positions. Additionally, Mississippi has a shortage of primary care physicians, making NPs essential in providing accessible and affordable healthcare services, particularly in rural and underserved communities.

3. Rhode Island

Despite being the country’s smallest state, Rhode Island ranks third in terms of NP demand. As a densely populated state with a high proportion of elderly residents, Rhode Island experiences a growing need for healthcare services. For every 1,000 open job positions, 2.9 are nurse practitioner positions in Rhode Island. NPs in Rhode Island are essential in delivering primary care, managing chronic illnesses, and reducing the strain on the state’s healthcare system.

4. Vermont

Vermont, known for its picturesque landscapes, is fourth on the list of states with a high demand for NPs. The state faces challenges related to its aging population and the prevalence of chronic diseases. According to the BLS, 2.74 out of every 1,000 job positions are nurse practitioner positions. Vermont relies on NPs to provide primary care services, particularly in remote areas where access to healthcare can be limited.

5. Missouri

Missouri rounds out the top five states with the highest need for Nurse Practitioners. The state’s healthcare system faces several challenges, including a shortage of healthcare providers, especially in rural communities. For every 1,000 job positions in Missouri, 2.59 are nurse practitioner positions. NPs in Missouri play a pivotal role in increasing access to healthcare services, improving health outcomes, and addressing the state’s healthcare disparities.

Understanding the National Nursing Shortage Crisis

Current Shortage Statistics

The American Association of Nurse Practitioners reports that the U.S. will need approximately 50,000 additional nurse practitioners by 2030 to meet growing healthcare demands. This shortage is driven by multiple factors including an aging population, increased chronic disease prevalence, and the retirement of experienced healthcare providers.

Contributing Factors to NP Demand

  • Aging Baby Boomer Population: As the largest generation in U.S. history ages, healthcare needs are exponentially increasing
  • Primary Care Provider Shortage: Nearly 20% of Americans live in areas with inadequate primary care access
  • Expanded Scope of Practice: Growing recognition of NPs’ ability to provide high-quality, cost-effective care
  • Healthcare Accessibility: NPs often serve as the primary healthcare providers in rural and underserved urban areas

Regional Healthcare Disparities and Rural Access Challenges

Urban vs. Rural Healthcare Distribution

Healthcare provider distribution remains heavily skewed toward urban areas, leaving rural communities severely underserved. Rural areas, which comprise 80% of U.S. landmass and house 20% of the population, have access to only 10% of physicians and advanced practice providers.

Geographic Barriers to Care

  • Transportation Challenges: Limited public transportation in rural areas creates barriers to accessing healthcare
  • Provider Recruitment Difficulties: Rural facilities struggle to attract and retain healthcare professionals
  • Economic Factors: Lower reimbursement rates and smaller patient populations affect practice sustainability
  • Infrastructure Limitations: Inadequate internet connectivity hampers telemedicine adoption

Technology and Telemedicine Integration

Bridging Geographic Barriers

High-need states are increasingly investing in telemedicine infrastructure to extend NP reach:

  • Store-and-forward technology for specialist consultations
  • Real-time video conferencing for patient care
  • Mobile health units equipped with telehealth capabilities
  • Remote monitoring systems for chronic disease management

Professional Collaboration

Technology enables NPs in isolated areas to:

  • Consult with specialists for complex cases
  • Participate in continuing education programs
  • Collaborate with colleagues for case discussions
  • Access electronic health records across healthcare systems

Making the Decision: Factors to Consider

Personal and Professional Considerations

When evaluating opportunities in high-need states, NPs should consider:

Lifestyle Factors:

  • Climate and geographic preferences
  • Proximity to family and support systems
  • Recreational and cultural opportunities
  • Cost of living and housing availability

Professional Factors:

  • Scope of practice regulations
  • Collaborative requirements
  • Malpractice insurance costs
  • Continuing education opportunities

Financial Considerations:

  • Base salary and benefit packages
  • Loan repayment program availability
  • Tax implications
  • Long-term earning potential

Future Outlook and Trends

Projected Growth Areas

Healthcare workforce analysts predict continued growth in NP demand, particularly in:

  • Geriatric care as populations age
  • Preventive and primary care services
  • Chronic disease management
  • Mental health and addiction services

Policy Changes Impact

Evolving healthcare policies may affect NP practice in high-need states:

  • Expanded scope of practice legislation
  • Medicare and Medicaid reimbursement changes
  • Interstate practice compacts
  • Telemedicine regulation modifications

Judy Daniels, MSN, RN, AGPCNP-BC
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