How to Start an NP Practice in Georgia: Nurse Protocol Agreements and Dual-Board Oversight
By Jody Mitchell, MD | June 15, 2025
An NP colleague in Atlanta had been working in urgent care for five years when she decided to open her own primary care practice. She found a collaborating physician, signed a lease in Decatur, and started building out her clinic. Three weeks before her planned opening, a healthcare attorney told her that Georgia requires a specific nurse protocol agreement -- not a generic collaboration agreement -- and that the agreement must comply with O.C.G.A. 43-34-25. She had to start the agreement process from scratch.
An NP colleague in Atlanta had been working in urgent care for five years when she decided to open her own primary care practice. She found a collaborating physician, signed a lease in Decatur, and started building out her clinic. Three weeks before her planned opening, a healthcare attorney told her that Georgia requires a specific nurse protocol agreement -- not a generic collaboration agreement -- and that the agreement must comply with O.C.G.A. 43-34-25. She had to start the agreement process from scratch.
The agreement she had signed was a template she found online -- a generic NP collaboration agreement designed for a state with very different rules. Georgia's requirements are specific, the terminology matters, and the wrong document can leave you practicing without proper legal authority.
Georgia is classified as a reduced practice state by the AANP. NPs here can evaluate, diagnose, treat, and prescribe, but only under a nurse protocol agreement with a physician. The state also has a unique dual-board oversight structure that adds a layer of complexity most NPs from other states do not expect.
The good news: Georgia's healthcare market is enormous and growing. Metro Atlanta alone has a population of over 6 million, and rural Georgia has some of the most severe provider shortages in the country. For NPs who understand the regulatory framework and plan accordingly, the opportunity is significant.
Georgia's Dual-Board Structure
Like North Carolina, Georgia regulates NP practice through two boards: the Georgia Board of Nursing and the Georgia Composite Medical Board. This dual oversight is codified in the Georgia Code, and both boards have authority over NP practice.
The Georgia Board of Nursing handles:
The Georgia Composite Medical Board handles: