Does the IMLC Include Nurse Practitioners or PAs?
No. The Interstate Medical Licensure Compact (IMLC) currently applies only to physicians holding an MD (Doctor of Medicine) or DO (Doctor of Osteopathic Medicine) license. Nurse practitioners (NPs), physician assistants (PAs), and other advanced practice providers are not included in this compact.
Why Aren’t NPs and PAs Included?
The IMLC is a state-level agreement specifically created by medical licensing boards. Since those boards regulate physicians — not nurses or assistants — they do not have authority to create compacts for other license types. NPs and PAs are governed by different state boards and credentialing pathways.
Is There a Compact for Nurse Practitioners?
Yes — but it’s still in development. The Advanced Practice Registered Nurse (APRN) Compact is a separate multistate licensing initiative designed for NPs and other advanced practice nurses. As of now, it’s not yet fully implemented.
Once enacted by at least seven states (the minimum required), it will allow eligible APRNs to hold one multistate license and practice across participating states — much like the nurse licensure compact (NLC) does for RNs and LPNs.
What About Physician Assistants?
There is currently no national compact for physician assistants. Each state licenses PAs individually, and the requirements can vary significantly. However, some states have introduced legislation to explore a PA compact in the future. Until then, PAs must apply separately to each state’s medical board.
Can NPs or PAs Use the IMLC If They Work Under a Physician?
No. Even if you work for a physician or are part of a multi-state medical group, NPs and PAs cannot apply under someone else’s credentials. Each licensed provider must qualify individually under their own license type. The IMLC is strictly for physicians — and eligibility rules are not transferable.
Are There Any Workarounds for Multi-State Practice?
If you’re a nurse practitioner or physician assistant, here are your current options:
- Apply independently to each state’s licensing board
- Work through an employer or medical group that helps manage licensing logistics
- Stay informed on the progress of the APRN Compact or any upcoming PA compact legislation
Some large telemedicine companies assist with multi-state licensing support for NPs and PAs, but you’ll still need to meet each state’s individual criteria.
Will NPs or PAs Ever Be Included in the IMLC?
Unlikely. The IMLC is not expected to expand its scope beyond physicians. Instead, separate compacts tailored to each license type are the path forward. These initiatives recognize the different training standards, scopes of practice, and regulatory structures for each profession.
Final Thoughts
If you’re a nurse practitioner or PA, the IMLC won’t apply to you — at least for now. But that doesn’t mean you’re stuck. Monitor the progress of compact legislation for your license type, and work with employers or legal support to simplify the multi-state process.
Healthcare is moving toward cross-border flexibility. While physicians have a head start with the IMLC, similar tools are in motion for other providers — and change is on the horizon.