The Virginia Nurse Practice Act, codified in Chapter 30 of Title 54.1 of the Code of Virginia, sets the licensing requirements, scope of practice, and disciplinary rules for every registered nurse, licensed practical nurse, and advanced practice registered nurse working in the Commonwealth. The Virginia Board of Nursing administers the Act. No one may treat patients as a nurse in Virginia without an active license or a valid multistate privilege, and violations range from a reprimand to permanent revocation.
Getting Licensed in Virginia
Two things have to happen before you can apply: graduation from an accredited nursing education program, and a passing score on the correct version of the NCLEX. That’s NCLEX-RN for registered nurses and NCLEX-PN for practical nurses.
The application itself carries a non-refundable fee of $190 for an RN license or $170 for an LPN license.1Virginia Department of Health Professions. Virginia Board of Nursing – Fees Every applicant also completes a criminal background check with fingerprinting through the Virginia Central Criminal Records Exchange. The Board reviews criminal history case by case, weighing the nature of the offense and how much time has passed.
Foreign-educated nurses have extra steps. Most must complete the CGFNS Certification Program, which combines a credentials evaluation, a qualifying exam, and proof of English proficiency through an approved test such as the TOEFL or IELTS.2CGFNS International, Inc. CGFNS Certification Program Only after clearing CGFNS can an internationally trained nurse apply for a Virginia license.
Practicing Under a License From Another State
Virginia belongs to the Nurse Licensure Compact. An RN or LPN who holds a multistate license from another compact state can practice in Virginia without a separate Virginia license, as long as the home-state license stays active.3Virginia Code Commission. Code of Virginia 54.1-3040.1 Through 54.1-3040.11 – Nurse Licensure Compact
If you move to Virginia and make it your primary residence, that changes. Under NLC rules effective January 2024, you have 60 days from the move to apply for a Virginia multistate license, and you’ll need proof of Virginia residency such as a driver’s license or voter registration card.4Virginia Department of Health Professions. Nurse Licensure Compact
Nurses coming from a non-compact state apply for licensure by endorsement. The Board grants endorsement if the original licensing requirements are substantially equivalent to Virginia’s; where they aren’t, the Board can require additional coursework or examination.
Military Spouse Portability
Federal law adds a separate pathway. A nurse who is a servicemember or military spouse and relocates to Virginia under military orders can have an existing nursing license recognized in Virginia by submitting an application with proof of orders, a notarized affidavit, and (for spouses) a marriage certificate.5Office of the Law Revision Counsel. 50 USC 4025a – Portability of Professional Licenses of Servicemembers and Their Spouses The license must be in good standing with no pending investigations. If Virginia cannot process the application within 30 days, it may issue a temporary license carrying the same practice rights as a permanent one.
Renewing Your License
Virginia nursing licenses expire every two years on the last day of your birth month. If you were born in an even-numbered year you renew in even years; born in an odd year, you renew in odd years.6Virginia Code Commission. 18VAC90-19-150 – Renewal of Licenses Renewal costs $140 for an RN and $120 for an LPN.1Virginia Department of Health Professions. Virginia Board of Nursing – Fees A lapsed license means you can’t practice until you complete reinstatement, and a long lapse can trigger a competency assessment before the Board will reactivate you.
To renew, you must satisfy one of several continuing competency options. The two most common are 30 contact hours of continuing education, or 15 contact hours combined with at least 640 hours of active nursing practice during the renewal period.7Virginia Code Commission. 18VAC90-19-160 – Continued Competency Requirements for Renewal of an Active License Alternatives include holding current specialty certification from a national certifying organization, completing post-licensure academic coursework, publishing nursing-related research, or teaching nursing courses.
CE hours must come from an approved provider. The recognized list is broader than many nurses assume and includes the American Nurses Credentialing Center, any state nurses association, the National Council of State Boards of Nursing, Area Health Education Centers, accredited colleges and universities, licensed health care facilities, and state or federal government agencies.7Virginia Code Commission. 18VAC90-19-160 – Continued Competency Requirements for Renewal of an Active License Online courses and employer-sponsored training count when the provider is on the approved list. Keep documentation on file for at least four years in case of a random audit.
What Each License Level Can Do
The Act draws clear lines around what each level of nurse can do. Stepping outside your scope is itself a disciplinary offense, so the boundaries matter.
Registered Nurses
RNs perform comprehensive patient assessments, develop and modify care plans, administer medications, start IV therapy, and carry out complex clinical procedures. They may delegate nursing tasks to LPNs or unlicensed assistive personnel, but Virginia sets specific delegation criteria: the RN must assess the patient, determine the task is appropriate for delegation, confirm the delegatee is competent, and maintain supervision.8Cornell Law School. Part V – Delegation of Nursing Tasks and Procedures The RN keeps full accountability for delegated tasks. Careless delegation is a common source of Board complaints.
Licensed Practical Nurses
LPNs work under the direction of an RN or physician. They monitor vital signs, administer medications according to established guidelines, perform wound care, and document interventions. LPNs cannot independently assess patients or create care plans. An LPN can carry out a plan and report observations; the clinical judgment calls belong to the supervising RN or physician.
Advanced Practice Registered Nurses
APRNs, including nurse practitioners, certified nurse midwives, clinical nurse specialists, and certified registered nurse anesthetists, hold a joint license issued by the Board of Medicine and the Board of Nursing.9Virginia Code Commission. Code of Virginia 54.1-2957 – Licensure and Practice of Advanced Practice Registered Nurses NPs can diagnose, prescribe, and manage treatment plans, and under federal Medicare rules may certify patient eligibility for home health services.10CMS. Advanced Practice Registered Nurses (APRNs)
A new NP in Virginia must practice under a collaborative agreement with a physician until accumulating the equivalent of at least three years of full-time clinical experience, as determined by the Boards of Medicine and Nursing. After crossing that threshold, an NP can apply to practice autonomously without physician oversight in the certified specialty area.9Virginia Code Commission. Code of Virginia 54.1-2957 – Licensure and Practice of Advanced Practice Registered Nurses Certified registered nurse anesthetists follow a different model and must practice under physician supervision at all times.
Prescribing Controlled Substances
An NP with prescriptive authority who wants to prescribe controlled substances must also register with the federal DEA. The DEA requires a separate registration at each physical location where the practitioner prescribes, and each location becomes subject to unannounced inspections.11Diversion Control Division | DEA. Registration Q&A Practitioners renewing or first obtaining a DEA registration also complete a one-time attestation that they’ve received at least eight hours of training on treating substance use disorders under the MATE Act provisions of the Consolidated Appropriations Act of 2023.12Diversion Control Division. Opioid Use Disorder – MATE Act Q&A
Virginia layers a state duty on top. Before prescribing opioids for treatment lasting more than seven days, or prescribing medications for opioid use disorder, the prescriber must query the Virginia Prescription Monitoring Program to check the patient’s controlled substance history.13Virginia Department of Health Professions. Prescription Monitoring Program – Frequently Asked Questions The Board of Nursing may add PMP requirements beyond that baseline, so check the Board’s current guidance.
Through December 31, 2026, DEA-registered practitioners may prescribe Schedule II through V controlled substances by telehealth without a prior in-person evaluation, under a temporary extension of pandemic-era flexibilities. The prescription must be for a legitimate medical purpose, issued through a real-time audio-video connection, and otherwise compliant with standard prescribing rules.14Federal Register. Fourth Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications Watch for permanent rulemaking after 2026.
Conduct Rules That Trigger Discipline
Virginia’s administrative code lists specific categories of misconduct under 18VAC90-19-230. They include fraud or deceit in obtaining a license, such as filing false credentials, and a long list of acts treated as unprofessional conduct: falsifying patient records, neglecting or abandoning patients, obtaining money from patients through misrepresentation, violating professional boundaries, and delegating tasks in violation of the delegation rules.15Virginia Code Commission. 18VAC90-19-230 – Disciplinary Provisions
Patient privacy carries especially steep consequences. Virginia law requires confidentiality, and federal HIPAA adds a separate layer of criminal liability. A nurse who knowingly obtains or discloses a patient’s individually identifiable health information without authorization faces up to $50,000 in fines and one year in prison for a basic violation, up to $100,000 and five years for offenses committed under false pretenses, and up to $250,000 and ten years if the disclosure was made for commercial advantage or personal gain.16Office of the Law Revision Counsel. 42 USC 1320d-6 – Wrongful Disclosure of Individually Identifiable Health Information Those federal penalties stack on top of whatever the Board of Nursing does with your license.
Mandatory Reporting
Virginia nurses are mandatory reporters of child abuse and elder abuse. The disciplinary code specifically lists failure to report suspected child abuse under Virginia Code § 63.2-1509, or elder abuse, as unprofessional conduct that can trigger Board action.15Virginia Code Commission. 18VAC90-19-230 – Disciplinary Provisions Nurses working in long-term care facilities that receive federal funding face additional federal timelines under the Elder Justice Act: suspected abuse involving serious bodily injury must be reported within two hours to the state survey agency and local law enforcement, and other suspected abuse within 24 hours. Federal civil penalties for failing to report can reach $200,000, or $300,000 if the failure leads to further harm.
How Discipline Works
The Board investigates complaints from patients, employers, colleagues, and self-reports. Allegations range from unprofessional conduct and substandard care to substance abuse, patient neglect, and fraudulent documentation. Under Code of Virginia § 54.1-3007, the Board can subpoena records, compel testimony, and hold formal hearings.17Virginia Code Commission. Code of Virginia 54.1-3007 – Refusal, Revocation or Suspension, Censure or Probation Statutory grounds for discipline include fraud in obtaining a license, unprofessional conduct, any felony conviction or misdemeanor involving moral turpitude, practicing in a way that endangers patient welfare, substance use that makes a nurse unsafe to practice, and having a license disciplined in another jurisdiction.
Penalties scale with severity. Minor infractions may draw a reprimand or required remedial training. More serious violations, such as causing patient harm or diverting drugs, can lead to suspension or permanent revocation. The Board may also place a nurse on probation with conditions like supervised practice or participation in the Virginia Health Practitioners’ Monitoring Program for substance abuse rehabilitation.18Virginia Code Commission. Code of Virginia 54.1-2517 – Health Practitioners Monitoring Program Committee When the Board finds a nurse poses a substantial danger to public health or safety, it can issue a summary suspension without a prior hearing and schedule a hearing within a reasonable time afterward.19Virginia Code Commission. Code of Virginia 54.1-2408.1 – Summary Action Against Licenses, Certificates, Registrations, or Multistate Licensure Privilege
Federal Fallout
State discipline can trigger federal consequences that outlast the Board’s penalty. The Board must report adverse actions, including revocations, suspensions, reprimands, and probation, to the National Practitioner Data Bank within 30 calendar days. Those reports are visible to hospitals, insurers, and other licensing boards nationwide.
A nurse convicted of a program-related crime, or found to have committed fraud, patient abuse, or certain controlled substance offenses, may also be placed on the HHS Office of Inspector General’s List of Excluded Individuals and Entities. Exclusion means no federal health care program, including Medicare and Medicaid, will pay for any item or service the nurse provides, orders, or prescribes. Employers that hire an excluded person face civil monetary penalties of their own.20Office of Inspector General | U.S. Department of Health and Human Services. Exclusions For most nurses, OIG exclusion effectively ends a career in health care.
Appealing or Reinstating a License
A nurse facing discipline has the right to an administrative hearing before the Board. If the Board upholds its decision, the nurse can appeal to the appropriate Virginia circuit court under the Virginia Administrative Process Act (Code of Virginia § 2.2-4000 et seq.). The court reviews whether the Board’s decision was supported by substantial evidence and whether proper procedures were followed. It does not retry the case.
Reinstating a revoked or suspended license takes a formal petition to the Board showing rehabilitation and full compliance with any conditions imposed. Cases involving substance abuse or mental health concerns generally require documented treatment records and a period of monitoring. The Board weighs the severity of the original offense, the time that has passed, and the nurse’s remediation efforts. Even when reinstatement is granted, expect probationary conditions or additional training before returning to unrestricted practice.