Written Protocol · NP
Mississippi Board-Approved Protocol or Standing Order for Nurse Practitioners
Required. The Board-Approved Protocol or Standing Order is the written instrument Mississippi law names for a Nurse Practitioner working with a physician. Below: the board that governs it, what it must contain, and the terms it has to carry.
No independent-practice pathway exists in current law (§ 73-15-20) — a collaborative relationship plus Board-approved protocol is required permanently, not conditioned on any hours/years threshold. A one-time 1,000-2,000-hour 'monitored practice' onboarding period (see prescriptive authority notes) does not end the collaborative requirement.
What a Mississippi Board-Approved Protocol or Standing Order must contain
Governed by the Mississippi Board of Nursing and the Mississippi Board of Pharmacy. Each numbered item is a statutory requirement the agreement must satisfy.
The Nurse Practitioner shall maintain a collaborative and consultative relationship with the Physician, as required by Miss. Code Ann. § 73-15-20, and shall practice under a Board-approved protocol or standing order. The Physician shall hold an unrestricted Mississippi medical license and unrestricted prescriptive authority.
Source: Miss. Code Ann. § 73-15-20
The Physician shall review a random sample of at least ten percent (10%), or twenty (20) charts, whichever is less, of the Nurse Practitioner's patients each month, and the Physician and the Nurse Practitioner shall hold documented, face-to-face quality assurance meetings at least quarterly. Patients may be treated at a location up to seventy-five (75) miles from the Physician's primary office without additional Board of Medical Licensure appearance; a site beyond that distance is a "free-standing clinic" requiring the Physician to appear before the Board of Medical Licensure, in person or by telephone, before collaborating with the Nurse Practitioner there.
Source: Miss. Admin. Code Title 30, Part 2630, Ch. 1, Rule 1.2-1.3
- The Board-Approved Protocol or Standing Order on file also carries 1 scope, 1 education, 1 registration clauses, generated in the document itself.
Statutes and rules cited
- Miss. Code Ann. § 73-15-20statute
Advanced practice registered nurse collaborative/consultative relationship and Board-approved protocol requirement, as compiled in the Board of Nursing's official Nurse Practice Act.
- Miss. Admin. Code Title 30, Part 2630, Ch. 1, Rule 1.2-1.3board rule
Mississippi State Board of Medical Licensure rules governing physician collaboration with nurse practitioners: chart review, quarterly QA meetings, and the 75-mile free-standing-clinic rule.
- Miss. Admin. Code Title 30, Part 2615, Ch. 1board rule
Mississippi State Board of Medical Licensure rules governing physician assistant practice protocols, supervision approval, on-site supervision of new graduates, and chart review.
- Miss. Admin. Code Title 30, Part 3001, Article XXXVIboard rule
Mississippi Board of Pharmacy rule authorizing pharmacists to initiate, modify, or discontinue non-scheduled drug therapy under a written protocol with a practitioner.
- Mississippi Board of Nursing, RN/LPN Renewal FAQboard guidance
Board of Nursing guidance confirming that continuing education is not required to renew an active RN license, except for reinstatement after a lapse of more than 5 years.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
Available remotely (no on-site requirement)
No mileage/radius requirement is codified for NPs (unlike PA's 30-mile rule) — statute/rule require only that the APRN 'be able to communicate reliably' with the collaborating physician (§ 73-15-20(7)(b); Admin. Code Part 2840, Rule 1.4C).
Supervision ratio
Not codified — no cap on file
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · controlled substances permitted
Before practicing at a site without a qualifying provider physically on premises, a new APRN must complete 2,000 monitored practice hours (if <1 year RN experience pre-APRN) or 1,000 hours (if ≥1 year) with a qualifying provider on-site (Part 2840, Rule 1.3) — a one-time site-specific onboarding step, not a pathway to eventual independence; the collaborative agreement itself never ends.
Written agreement
Required
Practice ownership (corporate practice of medicine)
Licensee-only ownership required — Same as the `pa` entry — Miss. Code Ann. § 79-10-31 restricts PC shareholders in medical-service corporations to licensed physicians; no NP co-ownership of medical PCs/PLLCs.
Legal sources for these rules (2)
- Miss. Code Ann. § 73-15-20 — Advanced Practice Registered Nurses
- Mississippi Admin. Code Title 30, Part 2840, Ch. 1 — APRN practice
About Mississippi's rules
Mississippi has no independent-practice pathway for NPs/APRNs — a collaborative relationship plus Board-approved written protocol is required for the life of the license. Multiple 2025-2026 NP full-practice-authority bills (H.B. 813, H.B. 98, S.B. 2178) remain unconfirmed as enacted — re-verify § 73-15-20 each session.
Other clinicians in Mississippi: see the state overview.