APRN`s roles include certified nurses, clinical nurses, certified nurse anesthetists, and certified nursing midwives. Currently, 21 states grant all APRN roles full power of practice, meaning that a CPA, control, and written practice conditions are not required. The remaining 29 states face regulatory barriers that impose a limited scope of practice for at least one of aprN`s four roles. Despite the growing demand for providers and the fact that APRNs have consistent positive outcomes, comparable to those of physicians, APRNs face considerable barriers to independent practice. One such barrier is the requirement that an APRN have a Collaborative Practice Agreement (CPA) with a physician. .