Duke University School of Nursing offers 4 Pediatric Nurse Practitioner pathways, split evenly between primary care and acute care:
Primary Care (CPNP-PC)
- MSN
- Post-MSN Certificate
Acute Care (CPNP-AC)
- MSN
- Post-MSN Certificate
All four are distance-based: online coursework, three required on-campus Nurse Practitioner Intensives in Durham, and clinicals placed near home. Duke does not offer a dual PC/AC plan of study.
Program Tracks Overview
| Program | Est. Tuition | Est. Duration | Credit Hours |
|---|---|---|---|
| MSN – PC | $103K | 2–2.5 yrs | 44 |
| MSN – AC | $101K | 2–2.5 yrs | 43 |
| Cert – PC | Varies | Varies | Gap analysis |
| Cert – AC | Varies | Varies | Gap analysis |
Tuition estimates multiply Duke’s 2026–2027 graduate nursing rate ($2,345/credit, no residency distinction) by the published credit total. One-time and per-semester fees are listed in the Tuition section.
- Why choose it: Duke is the only North Carolina school on this site with a pediatric acute care track, and its primary care MSN builds in a 4-credit developmental, behavioral, and mental health course that Duke says prepares graduates for dual behavioral and mental health specialty certification.
- Trade-off: About $103,000 in tuition for 616 clinical hours, which sits near the low end of the typical range, plus three required trips to Durham.
Quick Facts
| Feature | Details |
|---|---|
| Program Types | MSN; Post-Graduate Certificate |
| Population Focus | Primary Care (CPNP-PC) and Acute Care (CPNP-AC); no dual track |
| Format | Mostly Online: online coursework plus three on-campus NP Intensives |
| Clinical Hours | MSN: 616 (both populations); AC adds up to 150 intensive practicum hours |
| Clinical Placement | Facilitated by a placement team; $1,500 one-time placement fee |
| Distinctive Coursework | PC: 4-credit developmental, behavioral & mental health course |
| RN Experience | AC: 1 year acute care pediatric RN experience required |
| Admissions | Rolling review; interview by invitation; GRE not required |
| Tuition | $2,345/credit (2026–2027), same for all residents |
| Accreditation | CCNE (MSN and Post-Graduate APRN Certificate) |
Clinical Education
- Clinicals are completed near where you live, drawing on what Duke describes as a network of more than 2,000 facilities and practices.
- A clinical placement team facilitates sites. New MSN and certificate students pay a one-time $1,500 clinical placement fee in the first semester.
- Three Nurse Practitioner Intensives (N617, N618, N619) are 0-credit, mandatory, and require full attendance on campus. Duke announces dates several months ahead but does not publish their length.
- Intensives use a nationally certified simulation lab.
- Duke converts clinical credit at 56 hours per credit.
The placement team is the practical draw for distance students. Many online PNP programs leave preceptor searches to the student, and pediatric preceptors are scarce. Duke charges for the service rather than bundling it, so budget the fee alongside tuition.
A licensure issue for some states. Duke’s admissions page notes that Kansas requires 750 clinical hours for APRN licensure for students admitted after March 1, 2025, and that only Duke’s FNP and adult-gero acute care programs currently meet it. Applicants who plan to practice in Kansas should treat both PNP tracks as not meeting that state’s rule.
General Admissions
Both MSN tracks share one application. Duke reviews applications as they are completed and admits until programs fill, so early applicants see more open seats.
- BSN from an ACEN- or CCNE-accredited program, or an accredited ADN plus a bachelor’s degree in any field
- Preferred GPA: 3.0 on a 4.0 scale (holistic review)
- Current RN license in the state where you plan to practice
- Statistics: 3-credit general or introductory course with a C or better (AP Statistics score of 3+ accepted)
- Three professional references from the past five years, at least one from an MD, DO, PA, or NP
- Three personal statements, 2,000 characters each
- Resume or CV; unofficial transcripts for review
- Interview by invitation; GRE not required
- Rolling admissions; Duke does not publish priority dates by entry term
Duke’s admissions page is inconsistent on general nursing experience: one passage asks for at least one year, while its FAQ calls it recommended rather than required. The acute care requirement below is stated without that ambiguity.
MSN – Pediatric Nurse Practitioner, Primary Care
The estimated tuition for the MSN Pediatric Nurse Practitioner – Primary Care at Duke is approximately $103,180 (44 credits at $2,345/credit). The program can generally be completed in about 2 years with spring entry (6 semesters) or about 2.5 years with fall entry (7 semesters).
It prepares graduates for the PNCB CPNP-PC exam and practice in pediatric primary care clinics, school-based health centers, health departments, and hospital ambulatory settings. It is open to RNs without a pediatric experience gate.
MSN – PC Curriculum
The 44 credits split into a 12-credit MSN core, an 11-credit advanced practice foundation, and a 21-credit pediatric primary care sequence. The sequence alternates didactic and clinical courses across two levels, then closes with a 5-credit synthesis that includes an advanced practice skills workshop.
The behavioral health course is the curriculum’s main differentiator. N630A is a required 4-credit course in developmental, behavioral, and mental health assessment and management. Duke states the program prepares graduates for dual pediatric behavioral and mental health specialty certification. In the PNP field, the PNCB credential in this area is the Pediatric Primary Care Mental Health Specialist (PMHS); Duke does not spell out the PMHS eligibility path on the program page.
- N589: Advanced Physiology/Pathophysiology Across the Lifespan (4 cr.)
- N595: Physical Assessment & Diagnostic Reasoning (4 cr.)
- N596: Clinical Pharmacology for Advanced Practice Nursing (3 cr.)
- N630A: Pediatric Developmental, Behavioral & Mental Health Assessment & Management (4 cr.)
- N642 / N644: APN in Primary Care Pediatric Patients I and II (3 cr. each)
- N647 / N649: Pediatric Primary Care I and II: Clinical (3 cr. each)
- N691: Primary Care Pediatric Synthesis, with Advanced Practice Skills workshop (5 cr.)
- N617–N619: Nurse Practitioner Intensives I–III (0 cr., on campus)
More curriculum details are available here.
MSN – PC Clinical Requirements
- 616 clinical hours, stated as the minimum for the major
- N647: 168 hours; N649: 168 hours; N691: 280 hours
- Settings: pediatric primary care clinics, school-based health clinics, health departments, hospital ambulatory settings
616 hours clears the 500-hour PNCB floor and sits at the low end of the 600–750 range typical for a single-population PNP program. The largest block, 280 hours, falls in the final synthesis term, so clinical load peaks at the end.
MSN – PC Admissions
No track-specific requirements beyond General Admissions. There is no pediatric RN experience gate for the primary care track.
MSN – Pediatric Nurse Practitioner, Acute Care
The estimated tuition for the MSN Pediatric Nurse Practitioner – Acute Care at Duke is approximately $100,835 (43 credits at $2,345/credit). The program can generally be completed in about 2 years with spring entry (6 semesters) or about 2.5 years with fall entry (7 semesters).
It prepares graduates for the PNCB CPNP-AC exam and inpatient, intensive care, emergency, and subspecialty practice. Applicants need at least one year of acute care pediatric nursing experience, which rules out RNs coming from adult, outpatient, or general settings.
MSN – AC Curriculum
The acute care track shares the 12-credit MSN core and 11-credit foundation with the primary care track, then substitutes a 20-credit acute care sequence. It opens with a short pediatric primary care essentials course (3 credits plus 56 clinical hours) before two levels of acute care pediatrics and a 7-credit synthesis.
The essentials course is a foundation, not dual preparation. Graduates are prepared for CPNP-AC only; a nurse who wants both credentials would need the primary care certificate afterward.
- N628 / N629: Pediatric Primary Care Essentials and Clinical (3 cr. + 1 cr.)
- N660 / N661: APN in Acute Care Pediatric Patients I and Clinical (3 cr. + 1 cr.)
- N662 / N663: APN in Acute Care Pediatric Patients II and Clinical (3 cr. + 2 cr.)
- N692: Pediatric Acute Care Synthesis, with Advanced Practice Skills workshop (7 cr.)
- N617C–N619C: NP Intensive Clinical Practicums I–III (0 cr., up to 50 hours each)
More curriculum details are available here.
MSN – AC Clinical Requirements
- 616 clinical hours, stated as the minimum for the major
- N629: 56 hours; N661: 56 hours; N663: 112 hours; N692: 392 hours
- Up to 150 additional hours through the three intensive clinical practicums, which Duke offers only in its Neonatal and PNP-AC programs
- Settings: PICU and stepdown units, emergency departments, specialty clinics, inpatient specialty services, surgical and pre/post-operative units
The 616-hour minimum matches the primary care track. With the intensive practicums, an acute care student can log up to 766 hours, placing the track inside the typical 600–750 range or just above it. The practicum hours are capped (“up to”), so the guaranteed figure is 616. Nearly two-thirds of the minimum, 392 hours, falls in the final synthesis course.
MSN – AC Admissions
The acute care track adds one gate to the General Admissions requirements.
- At least one year of acute care pediatric nursing experience
Post-Graduate Certificates – Primary Care and Acute Care
Tuition for the Post-Graduate Certificate is not published as a total. Duke bills certificate students at the same $2,345/credit rate and states that required credits vary by major, so cost and length depend on how much prior graduate coursework transfers.
Duke offers the certificate in both Pediatric NP – Primary Care (CPNP-PC) and Pediatric NP – Acute Care (CPNP-AC). It suits a master’s-prepared nurse entering pediatrics, or a certified NP adding a pediatric population.
Certificate Curriculum and Clinicals
- Coursework is drawn from the matching MSN major’s specialty sequence; prior equivalent coursework may shorten the plan
- The current certificate page does not publish a fixed credit total or a minimum clinical hour requirement
- Clinical placement follows the shared model above, including the $1,500 placement fee
A certified FNP adding primary care pediatrics will likely need far fewer credits than an MSN-prepared educator or administrator. Because the total is unpublished, request the plan of study before committing.
Certificate Admissions
The certificate adds a required interview and an NC licensure rule that differ from the MSN application.
- Master’s degree from an ACEN- or CCNE-accredited nursing program, or a master’s in another discipline accepted by the specialty faculty
- Board-certified NPs practicing outside their certification area are eligible
- RN licensure or eligibility in North Carolina, with an exception for compact-state licenses under certain residency conditions
- Statistics: general or introductory course with a C or better
- Personal interview, with other arrangements for distance applicants
Tuition
Duke charges $2,345 per credit for 2026–2027 (up from $2,250 in 2025–2026), with no in-state discount. Both MSN tracks land near $101,000–$103,000 in tuition.
| Program | Est. Tuition |
|---|---|
| MSN – Primary Care | $103,180 |
| MSN – Acute Care | $100,835 |
| Certificate – PC or AC | Varies by gap analysis |
Calculated from Duke’s published per-credit rate and credit totals; not a university-published total.
Key Cost Takeaways
- One-time first-semester fees total about $2,895: matriculation ($500), transcript ($120), clinical placement ($1,500), certification readiness ($650), and the N595 clinical lab fee ($125).
- A $200 technology fee applies every semester, about $1,200–$1,400 over 6–7 semesters.
- Duke lists a health fee of $523.50 each fall and spring and $374 each summer. Confirm with Duke whether distance students are billed for it.
- Budget travel and lodging for three trips to Durham; Duke does not estimate these costs.
- Drug screening runs about $100–$200 per year, depending on clinical site.
- The rate rose about 4% from 2025–2026 to 2026–2027; expect further annual increases across a 2–2.5 year program.
- Merit scholarships and federal loans are available; the certificate page directs applicants to file the FAFSA.
Duke prices both tracks well above public options in the state. UNC Chapel Hill lists its MSN PNP-PC at roughly $42,300 in-state, but has no acute care track. For acute care, Duke is the North Carolina option. Full fee details are on Duke’s MSN tuition and fees page.
Why Choose This PNP Program?
Best suited for: pediatric RNs who want an acute care credential without relocating, and primary care students who want behavioral and mental health preparation built into the degree.
Best For
- PICU, pediatric ED, or inpatient pediatric RNs with a year of acute experience aiming for CPNP-AC
- Nurses outside North Carolina who can travel to Durham three times
- Primary care students planning to manage developmental, behavioral, or mental health concerns in practice
- Students who want help securing pediatric clinical sites
- Certified NPs adding a pediatric population through a tailored certificate
Biggest Strengths
Acute care access in North Carolina. Duke is the only North Carolina school profiled here with a PNP-AC track, and it delivers it at a distance. The intensive practicums add up to 150 hours of acute care clinical time that the primary care track does not include.
Behavioral health in the primary care core. N630A is required, not an elective, and Duke ties it to dual behavioral and mental health specialty certification. Students get this preparation inside the degree instead of through post-graduate coursework.
Placement support. A placement team facilitates sites through a large network, which reduces the preceptor search that slows many distance students.
Potential Drawbacks
- Tuition above $100,000 for either MSN, with no residency discount
- 616 required hours sits at the low end of the typical range
- Three mandatory campus intensives; length and dates are announced, not published in advance
- Acute care requires one year of acute pediatric RN experience
- Neither PNP track currently meets Kansas’s 750-hour APRN licensure rule
- No dual PC/AC track; a second population means a separate certificate
- Certificate credit totals and clinical minimums are not published
Bottom Line
Duke stands out for offering pediatric acute care at a distance and for building behavioral and mental health content into its primary care degree. Experienced acute care pediatric nurses who need to stay in their jobs and home state have few comparable options, and Duke adds placement support many online programs lack. The cost is the main limitation: roughly $101,000–$103,000 in tuition plus fees and travel, for clinical hours that meet but do not exceed the typical range. Primary care applicants focused on price should compare UNC Chapel Hill first. Acute care applicants in the Southeast, and primary care applicants who want behavioral health depth, have the strongest case for Duke.
Accreditation
Duke’s MSN and Post-Graduate APRN Certificate programs are accredited by the Commission on Collegiate Nursing Education (CCNE), per the School of Nursing bulletin. Duke states that its clinical requirements meet or exceed those of credentialing bodies including PNCB, preparing primary care graduates for CPNP-PC and acute care graduates for CPNP-AC.
Other PNP Programs in North Carolina
- University of North Carolina at Chapel Hill - Chapel Hill
View our comparison of all Pediatric NP Programs in North Carolina