The primary purpose of the nurse practitioner (NP) is to practice to the full extent of their education, training, and certification, without the clinical supervision or mandatory collaboration of physicians, as a licensed independent practitioner to provide specified medical or other patient care service. Basic Requirements: English Language Proficiency. In accordance with 38 U.S.C. 7403(f), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English. Graduate of a school of professional nursing approved by the appropriate accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission