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North Dakota CRNA License 2026: APRN Requirements, Practice Model, Salary

AH
Ava Health Team
··9 min read

North Dakota CRNAs are licensed as APRNs by the North Dakota Board of Nursing. North Dakota is a reduced practice state — a written collaborative practice agreement with a physician is required. North Dakota has NOT opted out of the federal Medicare CRNA supervision requirement. Fargo (Sanford, Essentia) and Bismarck (Sanford, CHI St. Alexius) anchor the major markets. North Dakota has no state income tax on most income (ND has very low flat rates compared to national averages), providing a meaningful take-home pay advantage. Rural North Dakota has persistent CRNA shortages.

Practice Model

  • Written collaborative practice agreement with physician required
  • North Dakota has NOT opted out of federal Medicare CRNA supervision requirement
  • ACT model: Sanford Medical Center Fargo (limited ACT), Essentia Health (Fargo)
  • CRNA-independent (with collaborative agreement): Most ND facilities; Sanford Bismarck, CHI St. Alexius, rural CAH hospitals
  • North Dakota's oil patch communities (Williston, Dickinson, Minot) have elevated healthcare demand from oil-industry workers and corresponding CRNA opportunities

Application Requirements

  • Active North Dakota RN license (compact or ND-issued)
  • Current NBCRNA certification
  • Official nurse anesthesia program documentation
  • Completed ndbon.org application + $75 fee
  • Criminal background check via North Dakota BCI

Processing Timeline

North Dakota Board of Nursing processes APRN applications in 6–8 weeks from complete submission. ND is among the more efficient compact states; applications with complete documentation process without notable delays.

CRNA Salary in North Dakota (2026)

MarketAvg CRNA SalaryNotes
Fargo$192,000–$222,000Sanford, Essentia; low COL; no income tax premium
Bismarck$190,000–$218,000Sanford Bismarck, CHI St. Alexius; state capital market
Grand Forks$188,000–$215,000Altru Health System; UND medical school proximity
Minot / Williston / Oil Patch$192,000–$225,000Trinity Health, oil-industry demand; CRNA-independent; signing bonuses

Top Employers in North Dakota

  • Sanford Health — Fargo + Bismarck + statewide; largest ND health system; CRNA-independent model at most facilities
  • Essentia Health — Fargo; CRNA-independent; regional referral center for northeastern ND
  • CHI St. Alexius Health — Bismarck; Catholic health system; CRNA-independent model
  • Altru Health System — Grand Forks; independent regional health system; CRNA-independent
  • Trinity Health (Minot) — North Central ND; CRNA-independent; oil patch demand

Related: CRNA Salary by State 2026, NP License North Dakota 2026, CRNA License Minnesota 2026.

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