1. A. A nurse practitioner may independently perform the following functions:

   1. (1) A comprehensive physical assessment of patients;

   2. (2) In accordance with Family Law Article, §2-301, Annotated Code of Maryland, certify to the clerk of the court that a:

      1. (a) 16 or 17 year old individual, who wants to get married without parental consent, has been examined and found to be pregnant or has given birth to a child; or
      2. (b) 15 year old individual, who has parental consent to be married, has been examined and found to be pregnant or has given birth to a child;
   3. (3) In accordance with Transportation Article, §13-704, Annotated Code of Maryland, certify to the Department of Transportation that an individual needs special consideration for certain health reasons;
   4. (4) In accordance with Health-General Article, §4-208, Annotated Code of Maryland, complete the date of birth and medical information required on a birth certificate;

   5. (5) In accordance with Health-General Article, §4-212, Annotated Code of Maryland, complete a death certificate if:

      1. (a) The medical examiner does not take charge of the body; and
      2. (b) The deceased was under the care of the nurse practitioner;
   6. (6) Establish medical diagnosis for common short-term and chronic stable health problems;
   7. (7) In accordance with Health-General Article, §4-212, Annotated Code of Maryland, file a replacement death certificate;
   8. (8) In accordance with Health-General Article, §5-601, Annotated Code of Maryland, issue a “do not resuscitate order” on a Maryland Emergency Medical Services form.
   9. (9) Order, perform, and interpret laboratory and diagnostic tests;
   10. (10) Order and perform diagnostic, therapeutic, and corrective measures;
   11. (11) Prescribe drugs;
   12. (12) Provide emergency care;
   13. (13) Refer patients to appropriate licensed physicians or other health care providers as needed;
   14. (14) In accordance with COMAR 20.31.03.01, certify that the utility client has a serious illness or the need for life-support equipment; and
   15. (15) In accordance with Health-General Article, §5-602, Annotated Code of Maryland, witness an advance directive.

2. B. A psychiatric nurse practitioner together with a physician is authorized to sign applications:

   1. (1) In accordance with Health-General Article, §10-615, Annotated Code of Maryland, to admit a minor to a facility for treatment of a mental disorder; and
   2. (2) In accordance with Health-General Article, §10-616, Annotated Code of Maryland, to admit an individual on an involuntary basis to a facility for treatment of a mental disorder.
3. C. A nurse practitioner may practice only in the area of specialization in which certified.
4. D. Nothing in this chapter limits or prohibits a registered nurse from performing those functions which constitute the practice of registered nursing as defined by law.
5. E. A nurse practitioner has a right and obligation to refuse to perform any delegated act, oral or written, if in the nurse practitioner's judgment it is unsafe or an invalidly prescribed medical act.
6. F. An individual certified under this chapter shall be subject to disciplinary sanctions set forth in Health Occupations Article, §8-316, Annotated Code of Maryland.
7. G. A nurse practitioner shall maintain medical records in accordance with Health-General Article, Title 4, Subtitle 4, Annotated Code of Maryland.

Authority: Family Law Article, §2-301; Health-General Article, §§4-208(a), 4-212, §4-403, 5-601(c)—(e), 5-608(c), 10-616, 10-628, 13-701, and 13-704; Health Occupations Article, §§8-205(a)(1), (2), (4), and (5), and 8-302; Transportation Article, §§13-616(a) and (b), Annotated Code of Maryland; Ch. 342, Acts of 2015; Ch. 468, Acts of 2015

Effective date: March 6, 1981 (8:5 Md. R. 473)

Regulation .01B amended effective August 29, 1994 (21:17 Md. R. 1439)

Regulation .02 amended effective June 7, 1993 (20:11 Md. R. 913)

Regulation .03A amended effective June 7, 1993 (20:11 Md. R. 913)

Regulation .04 amended effective June 7, 1993 (20:11 Md. R. 913)

Regulation .05 repealed and new Regulation .05 adopted effective June 7, 1993 (20:11 Md. R. 913)

Regulation .08 adopted effective August 29, 1994 (21:17 Md. R. 1439)

Chapter revised effective July 11, 2011 (38:14 Md. R. 790)

Chapter revised effective December 10, 2015 (42:24 Md. R. 1505)

Regulation .02A amended effective August 28, 2017 (44:17 Md. R. 835)

Chapter revised effective July 2, 2018 (45:13 Md. R. 667)

Regulation .03G adopted effective October 13, 2025 (52:20 Md. R. 1002)

Regulation .07C amended effective October 13, 2025 (52:20 Md. R. 1002)