Nurse Practitioner Salary in Iowa 2026,
$130,160 Median | BLS Data by City

Iowa nurse practitioners earn a median $130,160 a year, or $62.58 an hour, per BLS OEWS May 2025, with a band from $107,990 at the 10th percentile to $167,590 at the 90th. That is only 1.6% below the national median of $132,300 — a very small gap for a state with Iowa's cost of living, and one of the strongest cost-adjusted clinical positions in the Midwest.

Des Moines-West Des Moines, at $132,230, but only just — Davenport-Moline-Rock Island publishes $130,400, Cedar Rapids $129,890, Dubuque $129,620 and Sioux City $129,060. The whole table sits within about $3,200. That flatness is the point: an Iowa nurse practitioner gives up almost nothing in wage by working in Dubuque or Sioux City rather than the capital, while gaining substantially on housing costs. Note that the Davenport-Moline-Rock Island metro extends into Illinois.

Yes. Iowa is a full practice authority state. An ARNP licensed by the Iowa Board of Nursing may evaluate patients, diagnose, order and interpret diagnostic tests, and prescribe — including controlled substances under the appropriate registration — without a mandated collaborative or supervisory agreement with a physician. It is the reason nurse practitioners can serve as the primary provider in rural Iowa communities, and it materially strengthens their negotiating position relative to restricted-practice states.

Favourably, and more so than for lower-paid roles. Iowa now levies a flat individual income tax of 3.8%, down from a graduated schedule that had topped out at 5.7%, and the absolute saving scales with income — so it is worth more at the $141,940 seventy-fifth percentile than at the median. Combined with a wage only 1.6% below the national figure and Midwest housing costs, the after-tax, after-housing position for an Iowa ARNP is unusually good.

On the economics, yes. Full practice authority, a wage within 1.6% of the national median, a flat 3.8% income tax, low housing costs, and a projected national growth rate of 40.1% for the occupation. The honest counterweight is scale: Iowa employs 3,240 nurse practitioners at a location quotient of exactly 1.0, so the number of specialty and academic positions is small, and a nurse practitioner set on a narrow subspecialty may find the openings concentrated in Iowa City and Des Moines.

Because the credential is nationally scarce and nationally portable, and Iowa needs it more than most states do. A nurse practitioner licensed in Iowa holds a graduate degree and a national certification that would qualify them for a post in almost any state, so an Iowa employer bidding materially below the national rate simply loses the candidate. What makes the pressure sharper here is full practice authority combined with a rural population: nurse practitioners are not a supplementary staffing category in Iowa, they are frequently the provider keeping a rural clinic open. That is a strong position to negotiate from, and the 1.6% gap reflects it.

It pools population focuses that pay very differently. Psychiatric-mental health nurse practitioners, acute care NPs and those supporting procedural services sit toward the $141,940-to-$167,590 upper part of this band; primary care and outpatient family practice sit closer to the median. OEWS reports one row for all of them. The figure also excludes productivity and quality incentives, which are a normal part of Iowa health system compensation for advanced practice providers and can be worth a meaningful supplement that never appears in a wage survey.

Population focus first — the certification chosen at graduate school does more to determine lifetime earnings than any subsequent decision. Second, employer type: Iowa's large health systems pay on structured advanced-practice grades with incentive components, while independent rural clinics and federally qualified health centres price differently and may offer loan repayment instead of base salary. Third, call and coverage: an ARNP taking overnight or weekend coverage in a rural hospital is compensated for it separately, and in a state with Iowa's geography that arrangement is common.