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Whether you’re relocating to the island for a change of scenery or a military-serving spouse, practicing in Guam is a unique opportunity for nurse practitioners. Given that the island is a U.S. territory, it affords NPs the ability to practice outside of the states without dealing with many of the hassles associated with working internationally. How can nurse practitioners get licensed to practice in Guam?

Similarly to nurse practitioners working stateside, Guam requires NPs to obtain specific licenses and certifications in order to practice. Here are the steps you will need to take in order to practice as an NP in Guam.

Get your nurse practitioner certification

Once you’ve finished your NP program, you will need to take a national nurse practitioner certification exam. Guam recognizes the same certifying bodies as U.S. states. So, for example, a family nurse practitioner looking to relocate to the island may take either the ANCC or AANP certification exam.

Nurse practitioners are permitted to practice in Guam prior to passing a national certification exam. To do this, the NP must obtain a temporary license to practice which is valid for up to six months. The application for a temporary license application must also be signed by a collaborating physician licensed to practice in Guam.

Obtain local RN and APRN licenses

Once you have passed your NP certification exam, or if you are already certified, you will need to obtain both a nursing and advanced practice nursing license to practice in Guam. Start by applying for your RN license first, then apply for your APRN license. The application is done on paper, can be downloaded here, and should be submitted to the Guam Board of Nurse Examiners.

Apply for prescriptive authority

In the same vein as state-based NP’s, nurse practitioners prescribing in Guam must obtain a DEA number through the U.S. Drug Enforcement Agency. In addition, NPs must apply for a Guam controlled substances registration number in order to prescribe, administer, or dispense controlled substances. This is done through the Guam Department of Public Health and Social Services Division of Environmental Health Controlled Substances Program.

Comply with Guam’s NP scope of practice laws

Similarly to many U.S. states, Guam has several regulations limiting nurse practitioners’ scope of practice when it comes to both practice and prescribing. NPs working on the island must practice under a collaborative practice agreement with a physician. In the collaborative agreement, the physician must agree to provide consultation for and periodic review of the nurse practitioner’s services as well as a patient management protocol and system for patient referrals. Nurse practitioners practicing in Guam are permitted to prescribe, administer and dispense Schedule II-V controlled substances.

Meet requirements for licensure renewal

Nurse practitioners working in Guam must meet certain required metrics to keep their licenses up to date. Both RN and APRN licenses must be renewed every 2 years during which the NP must have completed at least 30 hours of continuing medical education. 


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One thought on “Island Living: How to Practice as a Nurse Practitioner in Guam”

  • Thanks for writing about my home island! It’s great to read about home in the media. I’ve been living in the stateside for several years now, and as much as my family asks me to move home – the limitations in scope of practice really discourage me from doing so, especially because many of the primary care MD’s are retiring.

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