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PAs are licensed by the state. medical licensing board, the PA-specific component of the. medical board, or a separate PA board. 11 All states and the. District of Columbia require PAs to pass the Physician. Assistant National Certification Examination adminis-.
Differences Between RNs and NPs. The big difference between RNs and NPs is the degree of autonomy an NP is granted. While NPs are required to work under the auspices of a physician, in many states, NPs may diagnose and treat patients in an independent location, without the constant vigilance of a physician.