(Canada Edition, 2024)

For those of you transitioning to the NP role, I hope to provide some guidance. In a series of posts I will review basic steps from point A (applying to programs) to point B (getting your licence). In previous posts, I reviewed how to become an NP in Canada, and how to become an NP in the U.S. In this post, I will provide a general overview of the licensing process in Canada. That being said, everyone’s experience is a bit different. Let’s review a basic checklist:

If you have passed all courses and obtained all mandatory clinical hours in your NP program, you will be eligible to complete a certification exam in your province, which is required to have your NP license. The exam must be recognized by your respective college. For example in Ontario, the College of Nurses of Ontario recognizes three exams for the primary health care NP license: the Canadian Nurse Practitioner Examination (offered at specific dates), and the Family Nurse Practitioner Certification Examinations from both the American Nurses Credentialing Center (ANCC) and the American Academy of Nurse Practitioners Certification Board (AANPCB) (offered at all times of the year). Similarly, the CNO recognizes certification exams through the AANPCB for the NP-adult license, and the Pediatric Nurse Practitioner Primary Care Certification Examination for the NP-paediatrics license.

These are computer-based exams taken at local testing centers. While applying for your certification exam, you can also start your NP licence application with your respective college.

Can I sign up for the NP certification exam while I’m still in school?

Generally speaking, yes, but check with your respective program and certification exam. I signed up for the AANPCB family nurse practitioner certification exam at the start of my final semester of school and submitted my unofficial transcript during the application process (which was accepted). I had many questions arise during the application process, but what helped was emailing my school program and the AANPCB who were both timely and helpful in their responses. For the AANPCB certification exam, typically you can sign up for your test date when you have completed your final day of your academic program. For example, my final NP program exam was on July 26, and I was able to sign up for the AANPCB certification exam on July 27.

Typically, you can do this during your final semester of your NP program. I did this concurrently with the certification exam application. For example, I started the CNO NP license online application, part of which entailed completing the Verification of Course Completion and Transcript Request Nurse Practitioner form (part 1 you complete, part 2 your academic institution completes and sends in to the CNO once you have completed the program). Double-check the process with your respective college / academic program.

How do I study for my certification exam?

Each exam has multiple study resources. Do your research and talk with practicing NPs who have been through the process already. There are many ways to study (textbooks, online review courses, podcasts, slide decks, practice exams, practice questions). Do what works best for you. Stay tuned for an upcoming blog post where I will cover study options for NP exams. 

What happens after I have written and passed my certification exam?

For the AANPCB computer-based exam, you are advised of your preliminary result the second you complete it. When you pass, your results will be released by the certification board to your respective college. In my experience, the AANPCB released my exam results to the CNO within a few days. The CNO subsequently advised me they received the results, and of outstanding items (e.g. complete the Jurisprudence ethics exam, pay my license fee, etc.). Once all license requirements had been met, I instantly had my NP license. If it has been a few weeks and your test results have not been released to your college by the certification board, reach out to the certification board to ask for an update re: when your results will be released. Once your official transcript has been posted through your NP program (it should have “degree conferred” on the transcript, or something along those lines), send in this copy to the certification board to close the loop, as required. In my experience, the AANPCB released by exam results to my college prior to me submitting my official transcript (I sent them my final transcript months later in October).

Do I need to apply for a billing number as an NP in Canada?

Provinces in Canada require NPs to have billing numbers. Once you officially have your license, apply for your billing number. In my case, I applied for my OHIP (Ontario) billing number, which had a quick turnaround time (typically 1-2 weeks).

Do NPs bill?

The compensation framework for NPs versus physicians is different. Physicians are typically compensated via a fee-for-service model (i.e. they bill the provincial health plan for services they provide to patients). NPs are typically paid on a salary basis. To date, no province or territory has assigned NPs billing numbers to directly bill a public health insurance plan (1).

Why do NPs need billing numbers?

It varies by province, but generally speaking, billing numbers are used for referring a patient to a specialist (the consulting physician needs the NP billing number to bill for the consult), and for tests (e.g. labs, diagnostic imaging) – these tests can be billed by the physician who interprets the test (2).

What professional liability protection can I use as an NP?

Similar to being an RN, you need to sign up for professional liability insurance before you begin to practice as a licensed NP. You must ensure that your PLP meets the standards set by your college and by-law requirements (3). A popular PLP in Canada is offered through the Canadian Nurses Protective Society (CNPS). They offer professional liability protection and core services, as well as the supplementary protection program (legal assistance for complaints to your college). Do your research and get the PLP that works for you.

Key Take Home Point: Complete your NP program, write a college-verified certification exam, and apply for your NP license through your college. If you have questions or are experiencing delays at any step during the process, go straight to the source and ask for help, whether that’s the certification board, your academic program, or your college/regulatory body.

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Related Posts

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How Do I Become a Nurse Practitioner in Canada?

How Do I Study for my Nurse Practitioner Certification Exam?

Should I Become a Nurse Practitioner?

How to Prepare for a Nurse Practitioner Job Interview

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Resources/Readings

1. Canadian Nurses Protective Society [Internet]. Ask a Lawyer: Nurse Practitioner Billing; July 2016. Available from https://cnps.ca/article/nurse-practitioner-billing/

2. Nurse Practitioner Association of Ontario [Internet]. NP FAQS; 2023. Available from https://npao.org/about-npao/npao-faqs/

3. College of Nurses of Ontario [Internet]. FAQs: Professional Liability Protection (PLP). Available from https://www.cno.org/en/maintain-your-membership1/professional-liability-protection/