Clinic & Practice · 11 min read · April 28, 2025
The COVID-19 pandemic accelerated telehealth adoption by approximately a decade. What was a niche service delivery model in 2019 became mainstream infrastructure by 2021. And while utilization has moderated from its pandemic peak, telehealth has permanently changed patient expectations and practice models in ways that create genuine opportunity for independent nurse practitioners.
A telehealth-first practice has structural advantages that brick-and-mortar practices do not: lower overhead (no lease, no front desk staff, no waiting room), geographic flexibility (you can practice from anywhere in states where you are licensed), and scalability (adding patients does not require adding physical space).
What Telehealth Can and Cannot Do
Before building a telehealth practice, be honest about its clinical limitations. Telehealth is excellent for:
Telehealth is not appropriate for:
Your practice scope should be defined by what telehealth can do well, not by what you wish it could do.
Licensing and Interstate Compact
You can only practice telehealth in states where you hold a valid NP license. The Nurse Licensure Compact (NLC) allows RNs to practice across member states on a single license, but the NP compact (APRN Compact) is not yet widely adopted — as of 2025, only a handful of states have enacted it.
If you want to practice telehealth across multiple states, you will need individual state licenses for each state. This is time-consuming and expensive (licensing fees range from $100–$500 per state), but it significantly expands your potential patient population. Many telehealth NPs hold licenses in 5–10 states.
Technology Requirements
A telehealth practice requires:
Getting Your First Patients
The hardest part...