Most nurse practitioners graduate from school with a background in some common specialty areas, including family practice, pediatrics, geriatrics, acute care, women’s health, or psychiatry. While these concentrations are a “safe bet” and can be applied in a variety of clinical settings, it can be more lucrative in the long run to take up a niche focus area. Here are some practice ideas for NPs looking to hone their skills and become a medical entrepreneur.
What is a niche skill?
A niche skill denotes a medical practice that few others are providing within a specific region or target population. Any nurse practitioner can open a family, mental health, or pediatric practice. But if you follow the Elite Nurse Practitioner Model of having a part time job, multiple side businesses, low expenses, and cash acceptance, these business models are not practical. For those who want to break away from the traditional healthcare model and practice on their own terms, choosing from a variety of specialty areas is necessary.
How can I determine which specialty area is for me?
Physicians have fellowships and residencies, where they have the opportunity to explore a number of concentrations and determine their true calling. Unfortunately, NPs are not awarded the same opportunities. For nurse practitioners looking for new practice ideas or specialties, you must take learning into your own hands.
Enroll in courses
If you decide to take a course, ensure that it is teaching you something specialized and marketable. When enrolling, prioritize courses that award CE so you are both learning something new and satisfying job requirements. It is also important to only participate in courses that are proven to be comprehensive and valuable. Enrollment fees aren’t cheap, so be sure you are getting information that is more in-depth than something that can be learned for free on your own or through a YouTube video.
Independent study
A more cost-effective way to explore specialty areas is through self exploration! Do some research online, buy some textbooks or reference guides, or speak one-to-one with professionals who work in the industries you are curious about. Independent learning can be done on your own time, and is more conducive to hectic schedules.
The best types of specialty areas for NPs
So, which niche skills and practice areas are out there for nurse practitioners to learn and implement into a side business?
Medical cannabis
Restrictions on cannabis are rapidly lifting across the country, and profits are skyrocketing as a result. If your state has the legality necessary to run a medical cannabis practice, consider pursuing this specialty area. You can perform evaluations for medical cards, prescribe cannabis-based remedies, and even offer education on the benefits of cannabis to your patients. Opening a medical cannabis clinic is cheap and simple with little liability.
Special offer: Elite NP’s Medical Cannabis Clinic course
Addiction management
This is a specialty area where few dare to venture. There is significant stigma around those battling addiction, and the populations in need of this type of care are known to be unreliable or uncooperative. But because few professionals are willing to pursue this specialty area, you will have little competition and cater to a large patient base. However, you may have to accept insurance or apply for grants to practice addiction management in some areas.
Aesthetics
More and more people are opting for cosmetic treatments, including fillers, Botox, and other minimally invasive injectables. However, the market in this specialty area is very flooded. It’s easy to get certified as an injector and these services are not necessarily confined to clinical care settings. If you are interested in this service line, try not to make it your sole source of income. It can be more lucrative to add aesthetics as a complimentary addition to an existing practice, like dermatology, gynecology, wellness, etc.
Related: Elite NP’s Aesthetics and Botox Clinic course
Weight loss
GLP-1 drugs are being prescribed now more than ever for weight loss. As the benefits of this medication class become recognized, the demand for prescribers continues to grow. A time may come where the market becomes flooded, so Elite NP recommends getting in on the gold mine as soon as possible. Be sure to develop a program that truly delivers results. The happier your patients are and the more visible weight they lose, the more likely they will be to refer others to your practice. Every weight loss regimen should be built upon these core tenets: decrease caloric intake, increase movement, balance hormones, improve nutrition.
Take Elite NP’s Definitive Medical Weight Loss Clinic course
Hormone replacement therapy
Elite NP founder Justin Allan touts the multitude of perks surrounding testosterone administration. “I’m passionate about men’s wellness,” Allan says. “Men between the ages of 30 to 55 are a forgotten patient group and optimizing their testosterone levels can be life changing. The same goes with post-menopausal women. If you can make them feel better, they will happily hand over money to you.”
Exclusive discount: Elite NP’s Hormone Replacement Therapy package
Transgender and LGBTQ+ focused care
The LGBTQ+ community is generally underserved in the medical sphere. Therefore, this population can be an ideal patient base for the NP looking to perform specialty medicine and help marginalized people in need. Transitional hormone therapy, PrEP, STD testing/treatment, and other LGBTQ+ specific medical needs are easy to learn and implement.

18 Responses
I am interested in offering allergy testing and treatments. Do you recommend a specific company or protocol?
I do not but there are so many guidelines available from the immunology and asthma societies that you can follow.
Live in Ohio want to do women’s health but cash only and been offered a room in chiropractors office. Also spoke with someone from OPTAVIA on health coaching. Can’t decide. Plus I need a collaborator. Also would love cannibas but again collaborating physician I need. I have a friend that is a doc left oncology and only does cannibas. 250 a patient. Maybe I should ask her if she would collaborate ?
Absolutely, see if you can use her as your collaborator. If you can, then first open a cannabis clinic. It is easy fast money with little liability. Then use those profits to open your other practices. It is what I did and I will explain it much more in my book I will be releasing in the next 1-2 months.
Dual certified and independent practice FNP, PMHNP in Virginia. I am currently working in a private practice women’s health office with two physicians. I am looking to start a women’s health practice that encompasses Integrative care and sexual wellness. I have another NP peer from urogynecology that practices sexual wellness and would like to provide bioidentical services. There are so many programs for bioidenticals, do you recommend one in particular?
Thank you so much. I look forward to your post all the time
I am interested in opening a cosmetic business such as laser etc.. What are your recommendations? The area I live has the potential!
The first thing you need to do before opening a practice is to find out who your competition is. And is there a need for this service in your area? Do not start something that is already being done. Find your niche!
I’m interested in doing a telemedicine clinic. Any ideas for a niche?
It really just depends on your interests and experience. I actually cover multiple ideas in the telemedicine course. Common niches are hormone replacement, weight loss, sick visits, etc… The trick though is to find a specific market to advertise towards. So if you decide to do sick visits for example, you will want to market it to a specific demographic: Single dads who like baseball, for example. I hope that makes sense.
Hey Justin! First off, thank you so much for sharing your knowledge. Forever thankful! I am curious on advice you may have for securing a collaborating physician? Thank you!
That can be difficult. Most NPs obtain one via a relationship. Do you know of any? Have you check out this article?
What does a medical cannabis clinic do or provide? I am naive. Can’t patients go to their doctors?
Medical cannabis clinics write the certifications to patients. Many primary care providers will not do it. So, it makes for a great cash based niche practice.
hI thank you so much for the work you are doing to help us advance our practice and independence as nurse practitioners! after your reading your blog, I would like to dig deeper and consider a medical cannabis evaluation as a service ad on to a clinic and i am in the process of opening for cancer patients. I am in California. Do you know how to start this process? are there sites i should be looking at for legal concerns/legalities and paperwork?
Thank you again!
Erica,
Unfortunately NPs cannot do cannabis evaluations in CA. I believe it is Physician only.
Hi Justin, I am a veteran thinking about a niche practice for performing compensation and pension examinations for veterans and DOT exams, since I am certified. I will not need a lot of medical equipment to perform either exams, mainly an office space and exam table would be the most. What are your thoughts on this as a niche practice? I would like to expand to provide more services later after I am well established.
It could be lucrative, but it will be time intensive