The First Lady of the United States is the hostess of the White House.
A PMHNP can often practice autonomously. In 27 states, nurse practitioners (NPs) already diagnose and treat with no physician involvement, and in 19 states prescribe medications independently. This is in contrast to 2008, when nurse practitioners could autonomously diagnose and treat in 23 states, and could only prescribe in 12 states.
The real debate is in the difference between a PA and a Nurse Practitioner (NP). A Nurse Practitioner is a nurse that has completed a master's degree (soon to be doctorate) in advanced practice nursing. In other words, they can diagnose and treat without the supervision of a doctor.