Advanced Nurse Practitioner: Growth, Organization, and Legislation
Significant Growth in Advanced Nurse Practitioners
The latter part of the 20th century witnessed substantial growth in the number of Advanced Nurse Practitioners (ANPs) and their national organizations. The ANP role diversified significantly, giving rise to new specializations such as:
- Emergency Nurse Practitioner
- Neonatal Nurse Practitioner
- Family Nurse Practitioner
- Acute Care Nurse Practitioner
By 1984, approximately 20,000 graduates from ANP programs were employed in various settings envisioned by the founders (Kalisch & Kalisch, 1986, p. 715):
- Outpatient clinics
- Health maintenance organizations
- Health departments
- Community health centers
- Rural clinics
- Schools
- Occupational health clinics
- Private offices
Expansion to Tertiary Care Centers
By the late 1980s, ANPs, particularly those with specialty training, were increasingly employed in tertiary care centers, reflecting their success in neonatal intensive care units (Silver & McAtee, 1988).
Organizational Development and Legislative Influence
The multiple roles of ANPs created competing interests, impacting their ability to unify on legislative issues. Key organizational developments included:
- Primary Health Care Nurse Practitioner Council – Established by the ANA to address legislative challenges.
- American Academy of Nurse Practitioners – Formed in 1985 as the first organization for ANPs across all specializations.
- American College of Nurse Practitioners – Created in 1995 to serve as a “SWAT team” on policy during President Clinton’s healthcare reform initiative, aiming to unite all ANP organizations.
Legislative Milestones in the Early 1990s
Federal legislation in the early 1990s, particularly the Controlled Substances Act, significantly impacted ANP prescriptive authority:
- DEA’s Initial Proposal (1991) – Proposed registration for “affiliated practitioners” with prescriptive authority tied to a collaborating physician’s number. This was criticized and revoked in 1992.
- DEA’s Amended Regulations (1992) – Introduced the category of “mid-level providers” (MLPs), allowing ANPs to receive individual DEA numbers starting with an M, provided they had state-granted prescriptive authority.
Key Outcomes
- The MLP provision, effective in 1993, greatly expanded ANPs’ ability to prescribe controlled substances (DEA, 1993).
Through these organizational and legislative advancements, Advanced Nurse Practitioners solidified their role and authority in the healthcare landscape, ensuring broader access to healthcare services and enhanced professional recognition.
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Multidisciplinary Licensing & Board Certifications:
Licensed as a Doctor of Chiropractic (DC) in Texas & New Mexico*
Chiropractic Licenses:
Texas DC License #: TX5807, Verified: TX5807
New Mexico DC License #: NM-DC2182, Verified: NM-DC2182
Nurse Practitioner Licenses:
Texas APRN License #: 1191402, Verified: 1191402 *
New Mexico CNP License #: 90560, Verified 90560
Florida APRN License #: 11043890, Verified: APRN11043890 *
Colorado License #: C-APN.0105610-C-NP, Verified: C-APN.0105610-C-NP
New York License #: N25929, Verified N25929
Georgia APRN License #: GAA-NP005701
Multi-State Advanced Practice Registered Nurse (APRN*) Texas & Multi-States
Multi-state Compact APRN License by Endorsement (43 States)
Compact Status: Multi-State License: Authorized to Practice in 43 States*
Nursing Licensure Compact: Updated Here
DEA Registration: (Drug Enforcement Agency Registered)
All medical (MDs) and family practice providers (FNP-APRN) are registered and licensed to offer various levels of medication.
Verify Providers' DEA Registration Here
License Verification Link: Nursys License Verifier
* Prescriptive Authority Authorized (DEA Registered Providers). Call if Required
Board Certification:
ANCC FNP-BC: Board Certified Nurse Practitioner*
Education:
Graduate with Honors: ICHS: MSN-FNP (Family Nurse Practitioner Program)
Degree Granted. Master's in Family Practice, MSN Diploma (Cum Laude)
Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
(Board Certified: Family Practice Nurse Practitioner—Multistate)*
(Licensed Nurse Practitioner & Chiropractor - Multistate)*
Clinical Director
DC & FNP License (Review Above)
Digital Business Card
NPI: 1205907805
Dr. Maria Cardenas, MD
(Board Certified: Internal Medicine)
(Licensed Medical Doctor)
Medical Director, Clinical Director & Collaborative Physician
NPI # 1164426748
MD License #: J2933
Licenses and Board Certifications:
MD: Medical Doctor
DC: Doctor of Chiropractic
APRNP: Advanced Practice Registered Nurse
FNP-BC: Family Practice Specialization (Multi-State Board Certified)
FNP-BC: Family Practice Across Life Span (Neonatal to Geriatrics)
RN: Registered Nurse (Multi-State Compact License)
CFMP: Certified Functional Medicine Provider
MSN-FNP: Master of Science in Family Practice Medicine
MSACP: Master of Science in Advanced Clinical Practice
IFMCP: Institute of Functional Medicine
CCST: Certified Chiropractic Spinal Trauma
ATN: Advanced Translational Neutrogenomics
Family with Primary Care Focus (Family Nurse Practitioner or FNP)
- The Family Nurse Practitioner (FNP) promotes, maintains, and restores health for individuals and families across the lifespan. FNPs also identify health risks, promote wellness, and diagnose and manage acute and chronic illness.
- The FNP focuses on comprehensive primary care, promoting healthy lifestyles for patients across the lifespan in settings such as private practice, physician offices, and community health centers.
Memberships & Associations:
TCA: Texas Chiropractic Association: Member ID: 104311
TNA: Texas Nurse Association: Member ID: 06458222
TNP: Texas Nurse Practitioner Association ID: 2025091511
AANP: American Association of Nurse Practitioners: Member ID: 2198960
ANA: American Nurses Association: Member ID: 06458222 (District TX01)
| Primary Taxonomy | Selected Taxonomy | State | License Number |
|---|---|---|---|
| No | 111N00000X - Chiropractor | NM | DC2182 |
| Yes | 111N00000X - Chiropractor | TX | DC5807 |
| Yes | 363LF0000X - Nurse Practitioner - Family | TX | 1191402 |
| Yes | 363LF0000X - Nurse Practitioner - Family | FL | 11043890 |
| Yes | 363LF0000X - Nurse Practitioner - Family | CO | C-APN.0105610-C-NP |
| Yes | 363LF0000X - Nurse Practitioner - Family | NY | N25929 |
| Yes | 363LF0000X - Nurse Practitioner - Family | NM |
90560 |
| Yes | 363LF0000X - Nurse Practitioner - Family | GA | GAA-NP005701 |
Dr. Alex Jimenez, DC, APRN, FNP-BC*, CFMP, IFMCP, ATN, CCST
(Board Certified: Family Practice Nurse Practitioner—Multistate)*
(Primary Care Across Lifespan—Neonatal / Pediatric / Adult / Geriatrics)
(Licensed Nurse Practitioner & Chiropractor - Multistate)*
Clinical Director
Digital Business Card
NPI: 1205907805
Dr. Maria Cardenas, MD
(Board Certified: Internal Medicine)*
(Licensed Medical Doctor)*
Medical Director, Clinical Director & Collaborative Physician
NPI # 1164426748
MD License #: J2933
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