Skip Navigation

The differences between a nurse practitioner (NP) and a clinical nurse specialist (CNS) can be subtle, but it is important to understand them when making your decision on which track to follow.

Put simply, NPs practice autonomously and collaboratively with other health care providers to perform assessments, order laboratory and diagnostic tests, diagnose, prescribe medications and treatments, and perform procedures within their authorized scope of practice. CNSs manage the care of complex and vulnerable populations, educate and support interprofessional staff to provide optimal care through use of best evidence, and facilitate a culture of safety within health care systems. NP and CNS roles are dependent upon individual attributes of the advanced practice nurse, the context of the practice setting, and characteristics of the patient population.

Both NPs and CNSs must obtain certification to practice from the appropriate certifying agency as well as state licensure as APRNs through their local Board of Nursing. Once certified, all advanced practice nurses will need continuing education and must be recertified every five years.

No matter your choice, the Johns Hopkins School of Nursing’s advanced practice programs can take you there.

Contact Admissions

similarities and differences

 Nurse PractitionerClinical Nurse Specialist

Typical Practice Areas*

*CNSs and NPs may work in any of these settings, but these are the most common locations for each

  • NP (usually defined by patient population)
  • Hospital
  • Private practice
  • Ambulatory clinics
  • Long-term care facility
  • Outpatient settings
  • CNS (can be defined by medical specialty, population, type of care, type of problem)
  • Hospital
  • Community/mental health clinics
  • Schools

Required Degrees



Common Duties

*applicable to both CNS and NP but more common among NPs

**applicable to both CNS and NP but more common among CNSs

  • Conduct health assessments and diagnostic testing*
  • Promote disease prevention and provide education to patients and families*
  • Diagnose and treat acute and chronic illnesses as primary care provider; provide referrals to specialists*
  • Write prescriptions (State dependent)*
  • Direct patient care*
  • Teaching/training
  • Expert consultation
  • Applies evidence-based research on nursing practices**
  • Systems and patient outcome improvements
  • Health care administration

Care Specialties

*DNP program available at Johns Hopkins School of Nursing

**Post master’s certificate available at Johns Hopkins School of Nursing

  • Adult primary
  • Adult-gerontology acute*
  • Adult-gerontology primary*
  • Adult psychiatric-mental health**
  • Family primary*
  • Gerontology primary
  • Neonatal
  • Pediatric acute**
  • Pediatric primary*
  • Women’s health
  • CNS
  • Adult-gerontological health*
  • Adult-gerontological critical care*
  • Adult gerontology
  • Community-public health
  • Home health
  • Pediatric critical care*


  • $92,670 (median) depending upon specialty, location, and experience—Bureau of Labor Statistics
  • $80,000-$120,000 depending upon experience—Healthcare Profession and Salary Database


NPs must meet NONPF core competencies: 2014 and 2017

CNSs must meet NACNS core competencies.