Medical advances improving premature newborn survival and higher rates of multiple births are driving growing demand for neonatal nurse practitioners. Duke University School of Nursing is working to fill that demand by preparing experienced NICU nurses to deliver advanced, evidence-based care to infants from birth through age two. The Neonatal Nurse Practitioner specialty at Duke is offered through the MSN program, with the option for graduates to continue into the Doctor of Nursing Practice program for advanced practice leadership training. Ranked #5 for MSN and #2 for DNP programs by U.S. News & World Report, Duke attracts nurses who want to become neonatal nurse practitioners equipped to manage complex cases, apply the latest research, and advocate for families.

“Our students are experienced neonatal nurses who bring a passion for improving health outcomes through family-centered care,” said NNP Program Director Dr. Desi Newberry. “They are compassionate, driven, and intellectually curious—always seeking to expand their clinical expertise and advocate for the tiniest patients and their families.”

What Is a Neonatal Nurse Practitioner?

A neonatal nurse practitioner, or NNP, is an advanced practice registered nurse who provides expert, evidence-based care to infants from birth through two years of age. The role is grounded in scientific knowledge of early human development—including embryology—and is uniquely designed to meet the complex needs of neonates and young toddlers during the most critical stages of life.

Neonatal nurse practitioners bring advanced clinical knowledge, leadership, and compassion to their practice, advocating for both immediate and long-term outcomes through family-centered care. What makes NNPs different than registered nurses is their ability to make independent clinical decisions, lead care teams, and guide family-centered interventions.

“Our curriculum provides a deep dive into neonatal pathophysiology, empowering students to make informed, evidence-based management decisions that directly influence patient outcomes,” Newberry said. “Students also gain the tools and mentorship to become leaders in quality improvement skills that are essential for driving innovation and improving care.”

What Does a Neonatal Nurse Practitioner Do?

The role of a neonatal nurse practitioner goes far beyond bedside care. In the NICU and other clinical settings, NNPs assess patients, diagnose conditions, interpret diagnostic tests, perform procedures, and develop individualized treatment plans. Their advanced training equips them to make complex clinical decisions and lead care teams with confidence. But the role doesn’t stop there.

“What truly defines our graduates is their ability to pair scientific knowledge with compassion,” Newberry said. “They advocate not only for the immediate health of their patients, but also for their long-term development and for equitable care across diverse populations.”

At Duke, NNP students lead with evidence-based practice and family-centered care. They collaborate closely with parents and caregivers, empowering families to take part in their child’s treatment. Through this approach, NNPs serve not only as clinicians, but also as educators, advocates, and changemakers in neonatal health.

How to Become a Neonatal Nurse Practitioner

If you’re exploring how to become a neonatal nurse practitioner—or wondering what degree you need to become a NICU nurse—the process involves advanced training and clinical experience. To become a NICU nurse practitioner, you must:

1. First earn your registered nurse (RN) license, typically by completing a Bachelor of Science in Nursing (BSN). Students could also obtain a Master of Nursing (MN).
2. After gaining experience as an RN, you’ll need to enroll in a graduate program that offers a neonatal nurse practitioner (NNP) track. These programs include advanced coursework in pharmacology, pathophysiology, and embryology, along with supervised clinical hours that prepare you to care for critically ill infants and young toddlers.
3. After completing your degree, you must pass a national certification exam to become a board-certified NNP.

Duke’s NNP specialty is designed for experienced neonatal nurses ready to step into leadership roles in the NICU and beyond. Applicants must hold a BSN and have at least two years of full-time clinical experience in a Level III or IV NICU prior to beginning clinical rotations. This ensures students enter the program with the foundational skills needed to build advanced competencies in neonatal care.

Duke also offers an NNP post-graduate certificate for nurses who already hold an MSN or DNP in another specialty.

How Long Does It Take to Become a Neonatal Nurse Practitioner?

The path to becoming a Neonatal Nurse Practitioner depends on your career goals. RNs with a BSN can work in the NICU, but those who want to work as a nurse practitioner must earn an advanced neonatal nursing degree. Duke’s neonatal nurse practitioner MSN program typically takes about two and a half years to complete, depending on where the student is in their career. Applicants must have two years of recent NICU experience before starting clinicals, though they can begin preclinical coursework while gaining that experience.

If a student wishes to earn their DNP after completing the MSN program, it will take an additional five semesters. This enables them to take boards and enter the NNP workforce while completing the remainder of their DNP courses.

To address the high demand for neonatal nurse practitioners and support a diverse range of students, Duke offers flexible enrollment options—including fall and spring start dates and an extended matriculation plan for students needing more time to complete studies.

“These options make it more feasible for working nurses and those with personal or professional obligations to pursue advanced education,” Newberry said.

Where Can Neonatal Nurse Practitioners Work?

Neonatal Nurse Practitioners (NNPs) practice in a wide variety of acute and community-based settings. Their specialized training in neonatal physiology and development allows them to deliver expert care in environments where critically ill or medically fragile infants require advanced support.

The typical settings where neonatal nurses can work include:

• Labor and delivery rooms. Collaborating with obstetric and neonatal teams to stabilize newborns during high-risk deliveries.
• Level III and IV NICUs. Providing the highest level of care for critically ill or premature newborns. This includes advanced life support, complex diagnostics, and comprehensive treatment plans.
• Newborn and special care nurseries. Managing infants who require intermediate levels of care, including those with mild to moderate medical needs.
• Outpatient specialty clinics. Serving high-risk infants and toddlers in follow-up settings such as Duke’s Special Infant Care Clinic (SICC), where developmental monitoring and continuity of care are key.
• Telehealth services. Utilizing remote technologies to support infants and families in rural or underserved areas, ensuring access to neonatal expertise beyond traditional hospital settings.

What Makes Duke’s NNP Program Stand Out?

In addition to a global network of more than 2,000 clinical sites, Duke’s NNP program offers a flexible, personalized path to advanced practice. While the program is primarily distance-based, students attend five on-campus intensives at Duke’s Center for Nursing Discovery, one of the most advanced simulation facilities in the country.

Small cohorts ensure that students build strong relationships with peers and faculty. Duke’s expert instructors are not only nationally recognized clinicians and researchers, they’re also committed mentors who support students throughout the program.

To meet the needs of working nurses, Duke offers flexible enrollment options, including fall and spring start dates and an extended matriculation plan. Whether pursuing the MSN, DNP, or post-graduate certificate, students can customize their academic journey to fit their personal and professional lives.

“Together, we cultivate a community that is as nurturing as it is rigorous and prepares students to become leaders in the NICU,” Newberry said.

Ready to Lead in Neonatal Care? Start With Duke’s NNP Program

Duke’s distance-based NNP program provides unparalleled resources and accessible, experienced faculty who are dedicated to mentoring and supporting students. Consistently ranked among the nation’s best, the program blends academic rigor with a collaborative, student-centered learning environment.

“The community feel at DUSON is a defining feature. Despite being distance-based, the MSN and other programs maintain a close-knit atmosphere where students, faculty, and staff build meaningful connections that last well beyond graduation,” Newberry said.

With a curriculum grounded in evidence-based care, clinical leadership, and compassion, Duke prepares NNPs to make a lasting impact in neonatal health.

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Ready to provide high-quality care to the tiniest patients and their families? Learn more about our Neonatal Nurse Practitioner MSN or register for an upcoming information session today.