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My nurse practice act in Georgia is vague with regard to supervision/collaboration issues. There is no state where the law requires physicians to sign every one of a nurse practitioner's (NP's) charts. In Tennessee, a physician must sign 20% of an NP's charts every 30 days. In Arkansas, there is a requirement for physician cosignature of NP orders. Practice protocols or facility requirements must specify when NP's orders must be cosigned.
Licensure and certification as a nurse practitioner (NP) demonstrate advanced education and clinical training. Together, they allow the NP to provide preventive and treatment services. These two credentials are tied together for NPs; they must be licensed in order to practice, and certification is sometimes a requirement for earning a license. To qualify for licensure and certification, aspiring nurse practitioners must become registered nurses (RNs) and then take advanced training.