Nurse practitioners per physician by state vary widely. Overall, the United States now has 43 nurse practitioners for every 100 physicians: 521,112 NPs and 1,203,692 physicians in the November 2026 NPI registry. In Mississippi the ratio is nearly one to one, and in 1,059 counties NPs outnumber physicians.
Key findings
- 43.3 nurse practitioners per 100 physicians nationally. Physician assistants add another 18.3 per 100 (220,301 PAs). Choose “Physician Assistants” in the map’s menu to see them.
- The South leads: Mississippi has 88.5 NPs per 100 physicians, Tennessee 76.3, Kentucky 72.6, Alabama 65.3, Arkansas 62.8 and Florida 59.9.
- Lowest ratios: Puerto Rico (1.3), Hawaii (25.5), California (27.7), the District of Columbia (27.8) and Oregon (32.1).
- NPs outnumber physicians in 1,059 counties. In 87 counties there are NPs but no physician at all.
Nurse practitioners per physician by state: highest and lowest
| Highest | NPs per 100 physicians | Lowest | NPs per 100 physicians |
|---|---|---|---|
| Mississippi | 88.5 | Puerto Rico | 1.3 |
| Tennessee | 76.3 | Hawaii | 25.5 |
| Kentucky | 72.6 | California | 27.7 |
| Alabama | 65.3 | District of Columbia | 27.8 |
| Arkansas | 62.8 | Oregon | 32.1 |
| Florida | 59.9 |
Why it matters
Nurse practitioners are registered nurses with graduate degrees who diagnose, treat and prescribe. In many rural counties they provide much of the primary care. How much they can do on their own, without a physician’s supervision or collaboration agreement, is set by each state; the American Association of Nurse Practitioners keeps a state-by-state map. A high ratio can mean NPs are filling gaps where physicians are scarce, or simply that a state trains and employs many NPs; the map can’t tell the two apart.
Compare with our doctors-per-capita map, which shows 144 counties with no physician, and with where physicians are oldest.
How we counted, and the limits
- Registered, not full-time. We count every NP and physician with an active NPI and a U.S. practice address, by primary specialty and county. Some work part time, in non-clinical jobs or in several places; the registry doesn’t say.
- All types of nurse practitioners are included: family, adult, pediatric, psychiatric, acute care and others. Physicians are MDs and DOs, counted the same way as on our density maps.
- Place is the practice address in the NPI registry, which is sometimes a billing office.
Find nurse practitioners near you with Find a doctor (choose “Nurse Practitioners” and “All clinicians”). What NPs and PAs do is also covered in our FAQ.
Source: contact.doctor analysis of the NPPES NPI Registry, November 2026 release.