General Information Fact Sheet
Nurse Multi-State Licensure - Interstate Practice
"A state nursing license recognized nationally and enforced locally"
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What is it?
Multi-State Licensure, hereafter referred to as MSL, will allow a nurse licensed in a compact state to practice across state lines in another compact state without having to obtain a license in the other state. A compact state is a state that has passed the interstate compact.
What is an interstate compact?
An interstate compact is an agreement between two or more states established for the purpose of remedying a particular problem of multi-state concern. Implementation requires enactment of an identical compact by each state legislature.
How does it work?
A nurse must have a license in the nurse's primary state of residence. If the primary state of residence is not a compact state, the nurse must have a license in every state where the nurse practices. For those nurses whose primary state of residence is a compact state, the nurse does not need a license to practice in another compact state.
State of residence is determined by one of the following:
- Driver’s license - AND -
- Voter registration displaying the primary state of residence; - OR -
- W-2 Form from Federal income tax return declaring the primary state of residency;
- OR -
- Military Form No. 2058 [PDF] – state of legal residence certificate may be accepted to document the declared state of residence.
- A federal government/military nurse practicing exclusively in federal or military systems, need only have one license from any state or territory per U.S. federal government/military policy. A federal or military nurse that also practices in a civilian health system is bound by the Compact law and rules. A federal/ military nurse that has proof of residency in a Compact party state may be issued a Compact license with a multi-state practice privilege. A federal/military nurse that does not have proof of residency in a Compact party state may be issued a single-state license regardless of where the nurse is residing. A military/federal nurse may not hold a multi-state license from more than one Compact state at a time.
- Nurses licensed in a compact state, i.e. Texas and whose primary state of residence is another compact state i.e. Maryland, may not hold an active license in Texas. The nurse will need a Maryland license. The Texas license will be made invalid. The nurse may practice in any compact state using the license from the nurse's primary state of residence as long as that state is a compact state.
- Nurses must have licenses in all non compact states where they work.
- Primary state of residence is best determined by the state used as residence on the federal tax return.
- The length of time a nurse is planning to work in a compact state outside the state of residence is not a criteria for the Compact.
- Until the national data base is available, the individual Boards will verify licenses for employers.
- The nurse would be responsible for complying with the provisions of the Nurse Practice Act where the nurse is practicing.
- Complaint and discipline process will not change - for nurses practicing under MSL, the Board can take action against their privilege to practice in the state.
- Advanced Practice Nurses will still be required to obtain advanced practice certification in each state where they are practicing.
