Who is in the Extended Class?

The Extended Class is for registered nurses (RNs) who have additional education and clinical experience that allows them to practice as Nurse Practitioners (NPs).

Registrants in this class have an expanded scope of practice that gives them the authority to diagnose, prescribe medication, perform procedures, and order and interpret diagnostic tests.

CNO offers three specialty certificates in the Extended Class: Adult, Pediatrics and Primary Health Care. Extended Class registration will be transitioning to a single classification for Nurse Practitioners, without specialty certificates, in July 2026. Check for updates on CNO.org.

Only nurses in the Extended Class at CNO can call themselves a Nurse Practitioner or NP.

Registration Requirements

Applicants to the Extended Class must meet all registration requirements for Nurse Practitioners before they can practice as an NP in Ontario.

Membership Obligations

Use of protected titles

Registrants in the Extended Class must identify themselves using the titles “Registered Nurse (Extended Class),” “RN(EC),” “Nurse Practitioner” or “NP” in their practice.

NPs may also use one of the following titles based on the specialty certificate they hold:

  • NP-Adult
  • NP-Pediatrics
  • NP-Primary Health Care

QA Program

Every nurse in the General and Extended classes is required to take part in CNO’s Quality Assurance Program, with some exceptions for nurses registered in another Canadian jurisdiction.

Compliance with NP practice standards

In addition to the practice standards that CNO registrants must follow, NPs must follow the Nurse Practitioner practice standard.

Recent practice in a clinical NP role

NPs must maintain clinical NP practice to remain in the Extended Class. This clinical practice must include:

  • direct interaction with the client population consistent with each specialty certificate they hold
  • the use of advanced nursing knowledge and decision-making skill in health assessment, diagnosis and therapeutics in the treatment of those clients

Each year, NPs must declare whether they have practiced as an NP within the previous three years. Those who have not are no longer eligible to stay in the Extended Class.

Education requirement to prescribe controlled substances

NPs can prescribe controlled substances once they have completed approved controlled substances education and are registered in the Extended Class with CNO. You can complete your controlled substances education during the application process or after you are registered as an NP.

Here is a complete list of approved NP courses and programs that integrate controlled substances education.

Professional liability protection

All Extended Class registrants must hold professional liability protection as set out in CNO’s by-laws. They must produce evidence of this protection whenever CNO asks for it.

Reporting requirements

Every Extended Class registrant must tell the Registrar and CEO about any of the following:

  • a finding of guilt in any jurisdiction relating to any offence
  • a charge in any jurisdiction relating to any offence
  • a finding of professional misconduct, incompetence or incapacity or any similar finding, in relation to the practice of nursing or another profession in any jurisdiction
  • a current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity, or any similar investigation or proceeding, in relation to the practice of nursing or another profession in any jurisdiction

Also, the registrant must provide any information requested by the Registrar and CEO under the authority of the Nursing Act, 1991, the Regulated Health Professions Act, 1991, regulations under those acts or CNO’s by-laws.

Citizenship/permanent residency/authorization to practice nursing

An Extended Class registrant must be one of the following:

  • a Canadian citizen
  • a permanent resident of Canada
  • someone authorized under the Immigration and Refugee Protection Act (Canada) to practice nursing in Ontario

If a registrant ceases to be any of these, then that registrant must immediately stop practicing and inform the Registrar and CEO in writing.

Terms, conditions and limitations

Every Extended Class certificate of registration is subject to the following terms, conditions and limitations.

You must provide to the Registrar and CEO the details of any of the following that relate to you and occur or arise on or after the day you were issued a certificate of registration:

  • a finding of guilt arising in any jurisdiction relating to any offence
  • a charge arising in any jurisdiction relating to any offence
  • a finding of professional misconduct, incompetence or incapacity or any similar finding, in relation to the practice of nursing or another profession in any jurisdiction
  • a current investigation, inquiry or proceeding for professional misconduct, incompetence or incapacity or any similar investigation or proceeding in relation to the practice of nursing or another profession in any jurisdiction

At the request of the Registrar and CEO, you must provide information that is required pursuant to the Nursing Act, 1991, the Regulated Health Professions Act, 1991, regulations under those Acts or CNO’s by-laws in the form and manner requested by the Registrar and CEO.

You must not engage in the practice of nursing unless you are a Canadian citizen or permanent resident of Canada or you have authorization under the Immigration and Refugee Protection Act (Canada) permitting you to engage in the practice of nursing in Ontario.

You must immediately advise the Registrar and CEO in writing if you are no longer a Canadian citizen or permanent resident of Canada or you no longer have authorization under the Immigration and Refugee Protection Act (Canada) permitting you to engage in the practice of nursing in Ontario. If you subsequently obtain Canadian citizenship, become a permanent resident of Canada or attain authorization under the Immigration and Refugee Protection Act (Canada) permitting you to engage in the practice of nursing in Ontario, you must immediately advise the Registrar and CEO in writing of that fact.

You must maintain professional liability protection in accordance with the requirements, if any, set out in CNO’s by-laws.

At the request of the Registrar and CEO, you must provide evidence satisfactory to the Registrar and CEO, and in the form and manner requested by the Registrar and CEO, that you maintain professional liability protection in accordance with the requirements, if any, set out in CNO’s by-laws.