“My multistate license lets me work anywhere in the U.S.”

What nurses hear

"I have a multistate license, so I can take an assignment or a telehealth patient anywhere in the country, no questions asked."

The reality

A multistate license grants a privilege to practice only in other Nurse Licensure Compact party states, roughly 40+ states, not every state. In a non-compact state you must obtain a license by endorsement before you practice. And even where the privilege applies, you must follow the nurse practice act, scope, and discipline rules of the state where the patient is located, which, for telehealth, is the patient's location, not yours. It's portability, not immunity.

Why this one spreads

• Marketing shorthand ("work in any compact state") gets shortened in conversation to "work anywhere."
• Telehealth blurs where practice legally occurs, many nurses assume it's their own location.
• Not everyone realizes a handful of large states are still non-compact.

The nuance that survives

• Both your home state and the state you're practicing in must be compact members for the privilege to apply.
• For telehealth, practice occurs where the patient is, so the patient's state must be compact (or you need its license).
• Non-compact destinations (a moving target) require licensure by endorsement first, budget several weeks.

Sources

NCSBN, Nurse Licensure Compact

Last verified: 2026-07-05

Frequently asked questions

Can I do telehealth for a patient in a non-compact state on my multistate license?

No. Telehealth practice occurs at the patient's location. If that state isn't a compact member, you need a license there by endorsement before seeing the patient.

Does the compact cover all 50 states now?

No, it's 40+ member states and growing, but several remain non-compact. Always confirm the specific state is a member before relying on the privilege.

Keep going

Related myths

• If I move to another compact state, my multistate license moves with me

  Moving resets it

• A compact license means I don't need continuing education

  Compact & CE

See all myths