Nurse Practitioners: Standing Out Through Niche Specialties

Updated on August 3, 2023
Nurse practitioner talking to a mom and her daughter.

An increasing number of nurse practitioners (NPs) are choosing to pursue independent practices. This is not surprising considering that the role of nurse practitioner ranked first on U.S. News & World Report’s “2023 Best Health Care Jobs” and second on its “100 Best Jobs of 2023.”  That demand, combined with excellent earning opportunities, makes the autonomy of entrepreneurship an attractive option for many NPs. 

In many states, independent NPs have a unique opportunity to combine their general practice expertise with niche specialties. For established independent NPs who are embedded in their communities and already a trusted resource, a segue to include niche specialization can be a natural and seamless transition. After all, NPs already have a keen sense of a patient’s unique needs, which enables them to create personalized care plans and offer valued individualized support.

Why Niche Specialties Come Naturally for NP Careers

Niche specialties also can help NPs differentiate themselves in a crowded market space and gain a competitive advantage. Whether it is being the only local nurse practitioner who specializes in pediatrics in a community with a large population of young families, or an adult-gerontology nurse practitioner in an area that is popular with retirees, specialization will help NPs stand out from the crowd. 

Conversely, NP niches can open doors for providing specialized care that can be unrecognized or underrepresented in the larger healthcare sector. In either situation, understanding the needs of the community and pursuing a particular specialty with this knowledge is key. 

Finding the Right Niche Specialty

NPs considering a niche should think objectively about what aspect of nursing care is of most interest and gives the greatest sense of accomplishment, as well as whether that specialty will benefit their current patient population in terms of improving health outcomes. The selection of niche specialties can enhance an entrepreneurial NPs ability to drive patient acquisition and profitability. Some questions NPs should ask themselves when choosing a specialty include:

  • What are your interests and passions?
  • What are your strengths and weaknesses?
  • What is the patient population you want to work with?

From a business perspective, it is essential to evaluate local markets and research what type of patient needs exist for a particular service in the practice area. Market research helps determine:

  • Which niche services are most in demand?
  • What is the profit margin for these services?
  • How much competition is in the geographic practice area?
  • Will niche services be sustainable?

For most independent NPs, it makes sense to maintain their general practice, at least initially, and integrate their niche specialty incrementally. Devoting one to two days a week to focus on the niche is a good start. 

In-Demand Niche Options for Independent Nurse Practitioners

For independent NPs, specialization in areas such as chronic disease management creates a particularly marketable skill set in addition to their existing scope of practice. These specialty areas are becoming increasingly important as healthcare continues to move towards a value-based care model where improved patient outcomes at reduced costs is the goal.

According to, the following are some of the top specialties for NPs. For independent nurse practitioners, these could provide ideal niche opportunities, either as a future practice focus area or an ongoing lucrative add-on service. 

  • Certified nurse midwives: Overseeing all aspects of pregnancy and working in a variety of settings, including home births
  • Acute care nurse practitioner: Treating and advising patients with short-term illnesses, either independently or with a collaborating physician
  • Adult-gerontology nurse practitioner (AGNP): Caring for an aging population by providing preventive care and assessing and treating illnesses
  • Family nurse practitioner (FNP): Providing preventive healthcare to adults and children
  • Pediatric nurse practitioners: Providing preventive care and treating illnesses and injuries for children and adolescents
  • Psychiatric nurse practitioner: Treating patients with mental health issues with therapy or medication
  • Women’s health nurse practitioner (WHNP): Providing reproductive care to women, such as routine and annual checkups and illnesses related to the reproductive system

Again, it is important to fully understand local patient demographics and demand before choosing a niche focus. NPs also may benefit from collaborations with affiliated organizations or institutions in the same or related specialty fields.

Additional Considerations for an NP Niche Practice

Specializing as an independent NP in a particular niche area can come with numerous benefits, such as increased expertise and the potential for increased earnings. However, career advancement will likely require obtaining additional certifications or credentials, leading to expenses that could impact profitability. 

NPs should investigate which certifications are necessary to practice in their desired niche, scope of practice laws as determined by their state board of nursing, and potential salary information to ensure it aligns with their business goals.  Additionally, NPs should consider exploring educational opportunities offered by renowned institutions such as the Yale University Graduate School of Nursing, which provides advanced nursing programs and resources that can further enhance their expertise and career prospects.

Aside from these considerations, many NPs find that focusing on a single niche or small number of specialties allows them to excel in their practices and enjoy professional success, including having more leverage when it comes to setting rates and fees and providing specialized high-quality services. 

Ultimately, finding the right balance between specialization and general practice is beneficial both short term and long term – not just for NPs but also for their patients who benefit from both comprehensive and specialized care.

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Brandy Lawson
Brandy Lawson

Brandy Lawson is a Senior Project Manager for NP Advantage, a solution suite developed to support the launch and growth of nurse practitioner independent practices. Created by the tenured healthcare consultants at Medical Advantage, NP Advantage provides the tools, technology, and training that are essential to establishing a thriving practice that is poised for success in an increasingly competitive healthcare landscape. For more information visit the NP Advantage website, or contact Brandy Lawson directly at [email protected].