For nurse practitioners · Virginia

A new license with autonomy stamped on it.

In an otherwise restricted, patient-care-team state, an NP applies jointly to the Boards of Medicine and Nursing, which issue a new license bearing an autonomous-practice designation authorizing practice without a practice agreement.

Find your page — we rank for your name →

Every state with a pathway

The moment

The designation you apply for

Virginia is otherwise a restricted, patient-care-team state; its autonomy is an earned upgrade delivered as an actual re-licensing. An NP with the equivalent of at least three years of full-time clinical experience — as determined by the Boards, documented by attestation — applies jointly to the Boards of Medicine and Nursing, which issue a new license bearing the autonomous-practice designation. HB 971, signed April 4, 2024, cut the wait from five years to three.

The requirement

Equivalent of at least 3 years of full-time clinical experience (as determined by the Boards), documented by attestation from a patient care team physician or an attesting nurse practitioner

The moment it attaches

Joint issuance by the Boards of Medicine and Nursing of a new license with the autonomous-practice designation

The timeline

Original 5-year pathway effective July 1, 2018; reduced to 3 years for applications received on or after July 1, 2024 (HB 971, signed April 4, 2024)

The statute

Va. Code §54.1-2957

The receipt

Other platforms would show a testimonial here. Gale has no Virginia NPs to quote, and we do not invent people — so here is the dated, sourced fact instead.

Virginia's autonomy is an earned upgrade in a restricted state, delivered as an actual re-licensing: the Boards of Medicine and Nursing jointly issue a brand-new license stamped with the autonomous designation — and HB 971 (signed April 4, 2024) cut the wait from five years to three.

Va. Code §54.1-2957

Scope and carve-outs

The grant and the strings, at equal weight

Practice without a written or electronic practice agreement in the practice category of the NP's certification and licensure — full scope within that category, with statutory duties to practice within their training and experience, consult other providers per clinical need, and maintain referral protocols for complex cases. NPs without the designation still require a patient care team physician.

What Gale runs

The inventory, split honestly. Nothing dark is dressed as live.

In the product today

  • Scheduling and the calendar.
  • Notes, with a scribe that drafts during the visit — you stay the final editor of every note.
  • Telehealth where the chart lives.
  • The patient record — see a sample chart, no signup.
  • Superbills for the patient who wants to claim out-of-network benefits.
  • The Fee Schedule — the one Gale document that states the fee.
  • Your practice page, in the public directory compiled from the NPPES registry.

Opening with the founding cohort

  • Concierge memberships — a monthly plan your practice sells on its own terms. Not sellable yet: enrollment fails closed behind a legal switch until counsel clears it. No countdown — when it clears, it clears.
  • The loop tracker — every referral, lab, and question a visible loop with an owner, a state, and a promised window. Closing one requires an outcome note; nothing silently expires.
  • The guided founding sequence — practice setup walked step by step with the first cohort: entity, posted prices, the practice page, the first visit.
The economics

The designation retires the supervising relationship and whatever it cost to keep. What Gale adds is built to stay just as legible.

Gale’s side of the ledger is deliberately short. The software is free, and Gale earns one flat all-in fee on a transaction — charged only when your practice is actually paid, never as a subscription, never with per-feature line items, never a spread on your rate. The number itself lives in exactly one document, on purpose, so it can never quietly say two different things in two places: the Fee Schedule states it.
The playbook

The deepest state cluster we have built is California’s — eight guides on the 103/104 ladder, cited to the statute and the board’s own filings. They are California’s rules, not Virginia’s; the same treatment is coming state by state. Until then, they show the depth of homework to expect from us.

The California playbook →
Questions with citable answers
A patient care team physician — or, since the recent amendments, an attesting nurse practitioner. The Boards of Medicine and Nursing jointly determine what counts as the equivalent of three years of full-time clinical experience; this page deliberately prints no hours figure, because the statute states the requirement in years, not hours.
Practice without a written or electronic practice agreement, in the practice category of your certification and licensure. The statutory duties that remain are clinical: practice within your training and experience, consult per clinical need, and maintain referral protocols for complex cases. NPs without the designation still require a patient care team physician.
Where to start

Your page may already exist

Gale publishes a public directory compiled from the NPPES registry. Find your listing, claim it, and see how you rank for your own name — that page is the front door your independent practice will be found through.

Find your page — we rank for your name →Browse the provider hub