How to Become a Nurse in North Carolina (RN, LPN or CNA)

Three nursing roles, two agencies

North Carolina licenses registered nurses (RNs) and licensed practical nurses (LPNs) through the North Carolina Board of Nursing. Nurse aides are different: the N.C. Division of Health Service Regulation, part of the Department of Health and Human Services, approves Nurse Aide I training, and its Nurse Aide I Registry is the listing a CNA needs to work in a nursing home, while the Board of Nursing keeps a second registry for the state's own Nurse Aide II level. All three paths share a shape, school then exam then a state record, but the schools, exams, fees and agencies differ. North Carolina is also a member of the Nurse Licensure Compact, so an RN or LPN who lives in the state holds a multistate license by default and a nurse moving in from another compact state can keep working while the paperwork catches up. This guide walks through each path as the Board and the Division describe it, then covers endorsement for nurses moving in, the compact, pay and renewal.

How to become a registered nurse in North Carolina

1. Graduate from a Board-approved RN program

The Board requires every examination candidate to complete a registered nurse education program approved by a nursing board. In North Carolina that means a diploma, associate degree or bachelor of science in nursing (BSN) program on the Board's approved list; graduates of programs approved by another state's board are eligible too. All three lead to the same license. The Bureau of Labor Statistics lists a bachelor's degree as the typical entry-level education for registered nurses, and many hospital systems prefer it, but an associate degree or diploma from an approved program makes you eligible to sit the exam. The Board does not allow anyone to challenge the exam without completing a program, military corpsmen included.

2. Apply to the Board of Nursing

Applications are filed online through the Board's Nurse Portal. The examination application is $75 and the criminal background check, completed inside the same application, is $38; both are non-refundable. You do not have to live in North Carolina to apply, test or be licensed, and the Board does not require citizenship, but a license by examination can only be issued to someone with a Social Security number. If your legal residence is in another compact state, the Board issues a single-state North Carolina license and adds multistate privileges once you send proof of North Carolina residency.

3. Have your program verified

For a North Carolina graduate, the program director reports your completion to the Board within 30 days of the end of the program; you send nothing. A graduate of a program in another state must have the school, or its transcript vendor, send a final official transcript showing the degree awarded and the completion date directly to the Board; transcripts that show you still in the program are not accepted, so do not order one until the degree is conferred.

4. Register for the NCLEX-RN

Register and pay the exam vendor, Pearson VUE, at least two weeks before you finish your program. The NCLEX registration fee is $200 in the United States; the National Council of State Boards of Nursing has announced that it rises to $350 on 1 February 2027. Once the Board has your application and payment, your program verification and your vendor registration, allow up to 10 business days for the Authorization to Test to arrive by email. The authorization is valid for 180 days; miss your appointment or let it expire and you register and pay the vendor again. The application and background check stay active for one year from the date the Board declares you eligible.

5. Fingerprints for the state and federal background check

Every applicant for licensure by examination or endorsement is fingerprinted for a State Bureau of Investigation and FBI criminal history check. Inside North Carolina you print the Live Scan forms from the Nurse Portal and take them to a sheriff's office, which transmits your prints electronically; outside the state you mail in a fingerprint card. The check is required for the license, not for the exam, and the Board recommends finishing it before you test so the license is not held up afterwards. For a mailed card the Board quotes an average of six weeks from the day it forwards your prints. A prior conviction does not bar you automatically: the Board may deny a license only when the conviction is directly related to nursing duties or is violent or sexual in nature, and it must weigh factors set out in law, including how long ago it happened and your record since.

6. Take the exam, retake as often as you need

Schedule the exam with the vendor and bring your authorization and an acceptable photo ID. The Board posts your license as soon as it determines you are eligible, provided the background check is complete; official results arrive from the Board about four weeks after the exam, and the vendor sells a quick-results service that shows them within two business days. North Carolina places no limit on the number of attempts. If you fail, you wait 45 days, file a new examination application ($75) and pay the vendor again ($200) before a new authorization is issued; re-examination packets go out within 30 days of an unsuccessful result. A candidate who fails the NCLEX-RN on the first attempt may choose to sit the NCLEX-PN instead, without the 45-day wait for that first practical nurse attempt.

7. Working before your results

The Board's examination pages describe no graduate permit, and the temporary license it offers is for nurses already licensed elsewhere who apply by endorsement. New graduates in North Carolina therefore start as licensed nurses only once the license posts. The Board no longer mails certificates or wallet cards; your certificate is downloadable from the Nurse Portal, and employers verify your license in the Board's database. Open positions for new graduates and experienced nurses are listed by employer on our registered nurse jobs in North Carolina hub.

How to become an LPN in North Carolina

The practical nurse path runs on the same rails as the RN path, with a shorter school and a different exam:

1. Finish a Board-approved practical nursing program. The Bureau of Labor Statistics notes these programs typically take about one year. To sit the NCLEX-PN you must have completed an approved practical nursing program; a partly completed RN program does not qualify.
2. Apply through the Nurse Portal for the examination application ($75) and the criminal background check ($38), and have your program verified the same way as an RN candidate: by your program director within 30 days if you studied in North Carolina, by a final official transcript if you studied elsewhere.
3. Register for the NCLEX-PN with Pearson VUE ($200, rising to $350 on 1 February 2027) at least two weeks before you finish, and wait for the Authorization to Test, valid for 180 days.
4. Complete the fingerprint check before you test if you can, so the license is not delayed.
5. Pass the exam. Attempts are unlimited with a 45-day wait between them; each retake needs a new $75 application and a new $200 vendor registration.

Many North Carolina LPNs later bridge to RN through an LPN-to-associate or LPN-to-BSN program; the Board then treats the graduate as a new RN applicant by examination. Current openings are on our LPN jobs in North Carolina hub.

How to become a CNA in North Carolina

North Carolina has two nurse aide levels. Nurse Aide I is the federal nursing-assistant credential: the Division of Health Service Regulation approves the training programs, writes the curriculum and keeps the registry, and a state-approved vendor gives the exam. Anyone who works as a nurse aide in a North Carolina nursing home must be listed on the Nurse Aide I Registry, RNs, LPNs and Nurse Aide IIs included. Nurse Aide II is a further level with an expanded task list, trained in Board of Nursing-approved programs and listed by the Board.

1. Complete a state-approved Nurse Aide I training and competency evaluation program, or, if you already have the training, a state-approved competency evaluation program. Federal rules set a minimum of 75 clock hours of training, and the Division sets the hours each program needs with the program itself. Programs run in community colleges, high schools, nursing homes and private schools; the Division publishes the list of approved training locations.
2. Take the state exam. The Division's approved vendor, Credentia, gives the National Nurse Aide Assessment Program exam, a written (or oral) test and a skills evaluation; a skills session needs at least five candidates or it is cancelled. The vendor's candidate handbook sets the fee and the format, and the Division's eligibility rules say who may test.
3. Get listed. Your name goes on the Nurse Aide I Registry within five business days of passing. There is no fee to be listed and none to renew.
4. Working while you train. Under the state's four-month rule, a nursing home may employ you as a nurse aide for up to four months before you are listed, provided you work full time and are actively completing the training and the exam. The four months are cumulative across every nursing home you have worked in, a facility may not restart the clock by rehiring you, and if you are not listed when they run out you may no longer work as a nurse aide in any nursing home.
5. Stay listed. The initial listing runs to the last day of the 24th month after you are added. To renew, you must have worked at least eight paid hours as a nurse aide, performing Nurse Aide I duties delegated and supervised by a registered nurse, within that period; the RN confirms it on an online employment verification form, and the new period runs 24 months from your last reported working day. Volunteer work, sitter work, private duty, orientation and time on payroll but not working do not count. An aide who cannot meet the renewal rule has to retrain.
6. Moving in from another state. North Carolina is a reciprocity state: an aide listed on another state's registry files a reciprocity application with the Division, which takes up to 10 business days, and must be listed in North Carolina before working as a nurse aide here.

To add Nurse Aide II, you must hold a Nurse Aide I listing with no substantiated finding of abuse, neglect or misappropriation, complete a Board-approved Nurse Aide II program (nursing students may qualify through equivalent coursework in their RN or LPN program), and apply through the Nurse Portal within 30 business days of finishing; the initial listing is $24. The listing renews every two years by the last day of your birth month for $24, on proof from a supervising registered nurse of at least eight paid hours of nursing care in the past 24 months. A Nurse Aide II listing cannot be transferred to or from another state. Openings for both levels are on our CNA jobs in North Carolina hub.

Licensed in another state? Endorsement and the compact

North Carolina is a member of the Nurse Licensure Compact, so an RN or LPN whose primary state of residence is North Carolina holds a multistate license that is valid in every other compact state, and a nurse who lives in another compact state with a multistate license may practice in North Carolina without a North Carolina license. See our compact nursing states list for every member. What a nurse coming from elsewhere does depends on where they live and what they hold:

• You hold a multistate license and still live in another compact state. Work in North Carolina on that license. The Board will not issue a North Carolina license to anyone who declares another compact state as their primary residence.
• You hold a multistate license and are moving to North Carolina. Under the compact rule in force since 2 January 2024, you have 60 days from the move to apply for a license by endorsement in your new home state. The Board lets you keep practicing on your old multistate license while your North Carolina application is processed, as long as it stays active and multistate, and asks you to change your address in the Nurse Portal as soon as you declare North Carolina as your residence; the North Carolina license then replaces the old one.
• You hold a license from a non-compact state, or a single-state license. Apply for licensure by endorsement: $150, plus the $38 fingerprint-based background check (prints taken for another agency cannot be reused). You qualify if you completed a program approved by the board that first licensed you, passed the NCLEX or the earlier State Board Test Pool Examination, hold an unencumbered license in every jurisdiction where you have ever been licensed, and have held an active license within the past five years; a nurse whose license has been inactive or lapsed for five years or more first completes a Board-approved refresher course. The application asks for your school, your original and current license, your last two nursing employers and every board that has ever licensed you, plus verification from the state of original licensure and, if different, the last state where you practised, ordered through the national verification service for $30 per license type where your state participates. The application and background check stay active for one year.
• Working while the file is processed. An endorsement applicant with an active single-state license, a North Carolina or non-compact-state address on file and no active multistate license elsewhere can ask for a non-renewable temporary license once the Board has received the fingerprints. It can only be requested within the first six months after applying, lasts up to six months or until the permanent license is issued, whichever comes first, and is issued once in a lifetime.
• Active-duty military and spouses may be eligible for a credit or waiver of the endorsement fee; the request goes in within 90 days of payment with a copy of the enrollment form, orders or dependent ID.

A North Carolina nurse with a single-state license who now lives in the state can upgrade to multistate by meeting the compact's uniform licensure requirements and emailing the Board's renewal unit a current North Carolina driver's license as proof of residency; a current background check must be on file.

What nurses earn, and the outlook

The Bureau of Labor Statistics' Occupational Outlook Handbook puts the national median annual wage for May 2025 at $97,550 for registered nurses, $64,400 for licensed practical and licensed vocational nurses and $42,260 for nursing assistants. For posted pay by city and employer in North Carolina, from Charlotte and Raleigh to Greensboro, Durham and Winston-Salem, see nurse jobs and pay in North Carolina; for how states compare, see the highest-paying states for nurses.

Nationally, the Bureau projects employment of registered nurses to grow 6 percent from 2025 to 2035, faster than the average for all occupations, with about 180,800 openings a year once retirements and career changes are counted. Licensed practical and vocational nurses are projected to grow 3 percent with about 51,800 openings a year, and nursing assistants and orderlies 3 percent with about 203,300 openings a year. North Carolina's large hospital systems and its long-term care sector are among the most active employers on our board; see where hospitals are hiring nurses now.

Keeping your North Carolina license or listing

• RNs and LPNs renew every two years by the last day of their birth month, online through the Nurse Portal, for $100. A first license or a reinstated one may run 13 to 24 months so that the expiry lands on the birth month. A license not renewed by the deadline expires at midnight that day and you may not practise until it is reinstated ($180, with a new background check if it has been expired six months or longer). There is no grace period on continuing competence: before each renewal you must have met one of eight options, among them 30 contact hours of continuing education; 15 contact hours plus 640 hours of active practice in the previous two years; current national certification; a Board-approved refresher course; or two semester hours of post-licensure nursing coursework. You keep the evidence and upload it only if the Board's random audit asks for it; a nurse who cannot show it goes inactive the day after the renewal date. Details by state are in our nurse CE requirements by state guide.
• Nurse Aide Is keep their listing by working at least eight paid, RN-supervised hours as a nurse aide in each 24-month listing period and having the RN verify it online. There is no renewal fee.
• Nurse Aide IIs renew with the Board every two years by the last day of their birth month for $24, with the same eight-hour rule verified by a supervising RN. A listing expired for up to 24 months is restored by passing the program's competency evaluation again; one expired longer than that requires a new Nurse Aide II program.

Sources

• North Carolina Board of Nursing, RN/LPN by Examination, NCLEX FAQ and Criminal Background Check / Live Scan, current requirements, read 6 October 2026.
• North Carolina Board of Nursing, RN/LPN by Endorsement and Licensure by Endorsement FAQ, read 6 October 2026.
• North Carolina Board of Nursing, Fee Schedule, updated 29 September 2026, read 6 October 2026.
• North Carolina Board of Nursing, Nurse Licensure Compact, Upgrade to Multi-State License and Nurse Licensure Compact FAQ, read 6 October 2026.
• North Carolina Board of Nursing, RN/LPN Renewal and Continuing Competence, RN/LPN, read 6 October 2026.
• North Carolina Board of Nursing, Nurse Aide II and Nurse Aide I, read 6 October 2026.
• N.C. Division of Health Service Regulation, Health Care Personnel Education and Credentialing Section, Nurse Aide I Registry: Education Requirements, State Examination, Nursing Homes, 120 Day Rule and Nurse Aide I FAQ, read 6 October 2026.
• National Council of State Boards of Nursing, NCLEX Fees and Payment and Nurse Licensure Compact, read 6 October 2026.
• U.S. Bureau of Labor Statistics, Occupational Outlook Handbook, May 2025 pay and 2025-35 projections: Registered Nurses, Licensed Practical and Licensed Vocational Nurses and Nursing Assistants and Orderlies, read 6 October 2026.