Complete Guide to the Neonatal Nurse Practitioner (NNP) Specialty

Last Updated/Verified: Jan 23, 2024

Definition: What Is a Neonatal Nurse Practitioner?

A Neonatal Nurse Practitioner (NNP) provides advanced medical care to high-risk newborns and infants. Risk factors include premature delivery, low birth weight, infections, heart conditions, and other issues. In fact, some neonatal specialists care for infants until the age of two, monitoring long-term conditions. NNPs perform a vital role in educating and encouraging mothers and other family members who have high-risk babies.

Neonatal nurses may have to stay current with new procedures and research by reading medical journals and papers. This role requires a strong educational background and willingness to continually learn new things. Neonatal nurses handle tiny patients who are often hooked up to life-saving machines that require constant monitoring and quick reactions.

Neonatal Nurse Practitioner Scope of Practice

Neonatal care demands quick thinking and steady nerves. Here are some of the duties you can expect in this role:

  • Starting and maintaining IV lines
  • Managing ventilators
  • Assessing vital signs
  • Drawing blood
  • Keeping worried families calm and up to date
  • Operating feeding pumps, incubators and ventilators

Although some of these duties overlap traditional RN roles, the specialization requires a gentle touch and manual dexterity to work with tiny patients. Neonatal nurses often train on the latest instruments and equipment adopted by their employers.

Skills & Abilities

A good neonatal nurse practitioner will possess the following traits:

  • Ability to handle intense stress
  • Preparedness to deal with life-and-death situations
  • Strong empathy
  • Compassion for infants, family members, and coworkers
  • Ability to use critical thinking without letting emotions interfere
  • Strong communication and interpersonal skills
  • Ability to discuss medical concepts in layman’s terms
  • Expert knowledge of breastfeeding
  • Attention to detail
  • Manual dexterity
  • Ability to make fast decisions
  • Expertise on a variety of technical equipment
  • Finesse with needles, feeding tubes and other specialized neonatal equipment

Neonatal Nurse Practitioner Certification & Subspecialties

After you complete your online neonatal nurse practitioner program, you’ll want to be sure to go through the certification process to show employers that you’re ready to do the job. Your online program will leave you well prepared for a certification exam, and completing your exam will show future employers that you have what it takes to effectively treat neonatal patients. Certification information is as follows:

Certified Neonatal Nurse Practitioner (NNP-BC)Neonatal Intensive Care Nursing (RNC-NIC)
OrganizationNational Certification Corporation National Certification Corporation
Number of Questions175175
Eligibility RequirementsCurrent, unencumbered RN license, graduation from an accredited neonatal nurse practitioner program (must have graduated after 2005)Current, unencumbered RN license, 24 months of specialty experience as an RN (minimum 2,000 hrs)

Students pursuing a neonatal nurse practitioner degree can choose a subspecialty if they wish. They can choose clinical requirements in the area they want to specialize in or take elective courses in the field. Subspecialties may require additional certifications, and are entirely optional.

NNP subspecialties include:

  • Electronic Fetal Monitoring
  • Neonatal Pediatric Transport
  • Oncology
  • Trauma
  • NICU

Besides specializing in the areas above, Neonatal Nurse Practitioners who work in neonatal intensive care units (NICU) have the following levels of skill and care:

  • Level I – These are nurseries for healthy infants that you find in any healthcare facility with an inpatient maternity ward. NNPs at this level may provide resuscitation and postnatal care — bathing, feeding, weighing and evaluating newborns.
  • Level II – These nurses take care of babies with moderate health issues. Infants here typically recover quickly. Sometimes, infants enter Level II care once they are released from NICU.
  • Level III – This nursery consists of NICU newborns, typically those born prematurely at less than 32 weeks of gestation or those who need surgery.
  • Level IV – This level includes regional NICUs where newborn infants in critical condition receive care. Newborns and infants here require around-the-clock monitoring and may need complicated surgeries.

Becoming a Neonatal Nurse Practitioner

To become a nurse practitioner in any specialty, prospective students must first enroll in an accredited program. As an in-demand specialty, there are online neonatal nurse practitioner programs available widely at colleges and universities around the country. Students can choose from several degree levels, including:

  • MSN-NNP Degree
  • Post-Master’s NNP Certificate
  • DNP-NNP Degree

Once the program has been completed, graduates will need to go through the process of becoming licensed and certified before they are ready for official employment as an NNP. Each state has different levels of practice authority, which will impact the roles and duties that an NNP can perform.

To prepare for a career as an NNP, RNs can look for employment in areas such as:

  • Labor & delivery
  • Postpartum nursing
  • Pediatrics
  • Neonatal intensive care units

Neonatal Nurse Practitioner Employment Opportunities

According to the U.S. Bureau of Labor Statistics, the job outlook for registered nurses is excellent, with a projected growth rate of 12% expected through 2028. Although the BLS doesn’t break out growth by specializations, the rigorous education and experience required to earn the certification may indicate an even bigger need for NNPs.

Common workplace settings for neonatal nurse practitioners include:

  • Clinics
  • Community-based settings
  • Hospitals
  • Neonatal intensive care units (NICU)
  • Research facilities
  • Special care baby unit (SCBU)
  • Community settings

Neonatal Nurse Practitioner Salaries

According to, neonatal nurse practitioners earn an average of nearly $125,000. That works out to around $60 per hour. The lowest 10% average over $105,000, while the highest 10% bring home approximately $144,000.

The main factors influencing salary include:

  • Geographic location
  • Level of education
  • Amount of experience as an RN and NNP
  • Work setting

This rewarding and challenging career involves awesome responsibilities. However, the salary potential may appeal to ambitious RNs who wish to grow their practice. Carefully weigh the options and consider whether you have what it takes to pursue the educational, experiential, and certification requisites for the job.