How Much do Neonatal Nurse Practitioners Make?

According to, neonatal nurse practitioners earn approximately $129,978 annually in the United States.

How much neonatal nurse practitioners make varies when comparing the top and bottom earners.

For instance, the highest-earning nurses earn about $150,144, while the lowest earn roughly $109,917.

Nevertheless, most NNPs make six figures per year.

Income Factors

Several factors influence the contrast in neonatal nurse practitioners’ pay.

It includes their location (the state they operate in), education level, training, and experience.

In addition, some negotiate their salary as part of a particular assignment or hiring stage, further influencing their pay.

Finally, benefits, bonuses, and perks can increase earnings and incentivize NNPs to maintain employment.


Work location is one of the most significant determining factors in an NNPs salary (besides education level).

Neonatal nurse practitioners working in large metropolitan areas make more than rural ones.

These healthcare professionals treat more patients on average and deal with various medical conditions.

Their salaries also vary dramatically from state to state.

For instance, NNPs in San Jose, CA, earn $163,122 annually, whereas those in Chandler, AZ, make roughly $128,418 yearly.

One big caveat for those who earn a higher salary is that some states have higher taxes and a higher cost of living.

As a result, states with a higher cost of living may nullify any financial advantage an NNP may achieve.

Picking a state with a low living cost and high pay (i.e., Texas) provides the best financial benefits for neonatal nurse practitioners.

Work Environment

Depending on where neonatal nurse practitioners work, their average annual salary varies.

For instance, NNPs in intensive care units earn more than those doing at-home services or operating at clinics.

The increased daily patient count and expertise required to manage ICU patients contribute to the higher pay.

In addition, hospitals pay more for ICU nurses due to the increased stress, responsibilities, and patient demand.

It helps healthcare facilities maintain employment by remaining competitive with other jobs.

Places Neonatal Nurse Practitioners Work:

  • General care
  • Hospitals
  • Intensive care units
  • Community health settings
  • At-home practices
  • Private offices
  • Clinics

Each employer has specific patient needs, demands, and staffing difficulties.

As a result, facilities most in need of neonatal nurses will offer competitive salaries to ensure they don’t leave.

Experience and Expertise

Before becoming NNPs, many RNs start as NICU nurses to learn about infant care and gain experience.

NICU nursing comprises four levels: level one, level two, level three, and level four.

Each level demands further training and knowledge because higher levels require more advanced medical care and aid.

First-level NICU nurses care for healthy babies, not requiring advanced support.

It’s the most accessible level for new NICU nurses learning to provide medical care to infants and newborns.

Level two NICU nurses provide care to babies born after 32 weeks of gestation.

They also care for infants with manageable medical conditions.

NICU nurses must acquire additional experience and training to become level-two nurses.

Next is the level three NICU nurses.

At this level, NICU nurses provide advanced medical care to babies with critical illnesses and extended gestation periods.

These nurses work more directly with physicians and healthcare specialists in subspecialties to ensure infants’ well-being.

In addition, they provide advanced imaging and respiratory support to monitor the infant’s health status in case more invasive care is necessary.

Finally, level four NICU nurses deliver the highest level of care.

They work with infants dealing with the most acute illnesses and medical conditions.

As a result, these specialists operate in high-level departments that perform surgical repair and invasive treatments.

After working as a NICU nurses and gaining experience, some pursue advanced education to become neonatal nurse practitioners.

Neonatal Nurse Practitioner Overview

Neonatal nurse practitioners provide care to newborn babies within their first month.

Due to the many medical complications newborn babies can face, NICU nursing is a vital component of healthcare.

It’s also an essential asset to the communities they serve because they’re accountable for ensuring newborn babies heal appropriately and have the best chances of survival.

Depending on their level of training and education, neonatal nurses may be trained in neonatal resuscitation (generally required to become a neonatal nurse), medication application and usage, specialized training in dealing with abnormalities, congenital disabilities, various other birth complications, and other neonatal-related training.

Those who become neonatal nurse practitioners prescribe medications, develop treatment plans, and act as primary care providers.

With that said, responsibilities vary depending on their scope of practice and state laws.

Some states allow NNPs to operate with little oversight, while others require a physician to sign off on specific tasks.

Work Responsibilities

Neonatal nurse practitioners manage numerous responsibilities on a given day.

For instance, they monitor newborns’ vitals with specialized equipment, feed infants, change diapers and bathe them.

They also provide parents with healthcare advice, perform medical procedures, diagnose medical conditions, and develop treatment plans.

Finally, NNPs frequently soothe premature and ill newborns to ensure they receive necessary emotional and physical support.

Responsibilities include:

  • Assisting physicians with treatments
  • Feeding infants
  • Diaper changes and bathing
  • Utilizing specialized NICU equipment
  • Performing medical procedures
  • Comfortable premature and ill newborns
  • Providing 24/7 support and medical aide

NNPs work around the clock to ensure newborns and babies receive adequate medical care.

As a result, they must always be available to monitor and treat infants.

Infants require constant attention and monitoring because anything can cause significant health issues if not addressed immediately.

Advanced Care

Because neonatal nurse practitioners have more training than NICU nurses, they provide more direct support.

It includes patient education, disease prevention, infant diagnosis, treatment plans, and acute care.

NNPs also perform numerous procedures, from intubation to resuscitation.

NNP Procedures:

  • Intubation
  • Central line placement – PICC, Umbilical
  • Chest tube placement
  • Arterial puncture
  • Lumbar puncture
  • Needle aspiration
  • Resuscitation

Finally, there are subspecialties for neonatal nurse practitioners who want to specialize in particular infant care areas.

It allows them to hone their expertise further to provide comprehensive care for specific medical conditions.