Requirements for Canadian RNs to Work in the U.S.
Written by Jennifer Slatten, Director of Operations and Canadian Liaison at Axis Medical Staffing. Last reviewed September 2026.
Your Guide to Working in the US as a Canadian RN
Why Canadian Nurses Choose Travel Nursing in the US
Every year Canadian RNs cross the border to work in US hospitals, and most of them come for the same reasons. Thirteen-week contracts let you choose where you live and work, a winter in Arizona or Florida, a summer in Seattle or Maine, a year of different cities if you want it. You get experience inside large US health systems, with specialties and unit types you may not see at home, and a US license and work history that stay with you for the rest of your career. And the TN1 visa makes it possible for Canadian nurses specifically, no sponsorship lottery, no years of waiting.
Where Do You Even Begin?
That’s the question we hear most. The process has eleven steps across four different organizations, Pearson VUE, TruMerit, a state board of nursing, and US Customs and Border Protection, and nobody hands you the order. Miss a step and you lose months. Do them in the right sequence and most Canadian RNs are working in the US within three to four months.
That’s what Axis is here for. Our Canadian Liaison has guided Canadian nurses through this exact process for years, and your recruiter stays with you from your first document through your final shift. Below are the eleven steps, in order, with what to expect at each one.
3-4 months
Typical timeline from first document to first shift
TN1 visa
Issued at the border for Canadian RNs
$940 USD
NCLEX and VisaScreen fees combined. State license fees vary
19 states + DC
Issue an RN license without a Social Security Number
Steps to Working as an RN in the United States
Step 1: What does U.S. healthcare employment offer Canadian nurses?
- Thirteen-week contracts in the state and season you choose, experience inside large US health systems and specialties you may not see at home, and a US license and work history that travel with you for the rest of your career. Most Canadian nurses working in the US start with one assignment and end up doing several.
- Estimated Timeframe: 1-2 weeks
Step 2: How do I work with Axis Medical Staffing?
- Fill out the form at the top of this page and Jennifer, our Canadian Liaison, will reach out to talk through where you are in the process, which state fits your situation, and what to start first. No cost, no commitment. It’s a conversation about whether travel nursing in the US is the right move for you.
- Estimated Timeframe: 1 week
Step 3: What are the minimum requirements for Canadian RNs to work in the U.S.?
- Three things. A nursing degree from an accredited school, an active Canadian RN license in good standing, and at least two years of recent nursing experience. You also need Canadian citizenship for the TN visa. Permanent residents who hold another citizenship need a different work authorization, and that’s worth sorting out before you start the licensing process.
Step 4: Do I need to pass the NCLEX-RN exam?
- Task: Prepare for and succeed in the NCLEX-RN exam, essential for obtaining a U.S. nursing license for Canadian RNs.
- Details: The Pearson VUE registration fee is $200 USD. Testing at a Pearson VUE center in Canada or the United States adds no scheduling fee. A $150 international scheduling fee applies only if you test outside the United States, Canada, or Australia. The fee rises to $350 on February 1, 2027, and anyone who completes registration before that date pays $200 even if the exam is later. The NCLEX is administered only at Pearson VUE test centers, there is no online version.
- Estimated Timeframe: 2-6 months
- Cost: $200 USD ($350 starting February 1, 2027)
Step 5: How long does it take to get a valid Canadian passport?
- Task: Verify that your Canadian passport is current, a necessary step for international nursing in the USA.
- Details: Standard processing is 10 business days in person at a passport office or 20 business days by mail, and since April 2026 the Government of Canada refunds the fee automatically if a complete application takes longer than 30 business days. Urgent service in two to nine business days is available with proof of travel.
- Estimated Timeframe: 10–20 business days standard (2–9 business days urgent)
Step 6: How do I complete my VisaScreen® Certification?
- Task: Secure a VisaScreen® Certificate, proving your credentials meet U.S. standards, a critical step for Canadian nurses in the USA.
- Details: Offered by TruMerit, formerly CGFNS International. The application fee is $740 and certificates are issued digitally. TruMerit reports about 14 weeks on average to receive primary source documents from schools and regulators, and once everything is in, 90 percent of certificates are issued within 3.5 business days. Expedited review is $650 and prioritizes processing within 10 business days after all documents are received. The application must be completed within 12 months. Certificates are valid for 5 years, renewal is $475 within six months of the expiration date.
- Estimated Timeframe: ~14 weeks average (10 business days expedited)
- Cost: $740 USD ($475 USD renewal within six months of expiration; $650 USD optional expedited review)
Step 7: How do I apply for a state RN license?
- Task: Pursue state nursing licensure in the U.S., choosing states that fit your plans.
- Estimated Timeframe: 2-4 months
Which States License Canadian RNs Without a Social Security Number?
Nineteen states and DC issue an RN license without a Social Security Number, eight more accept your application and hold the license until your SSN arrives, fourteen require one to apply, and eight don’t say. Every state is listed below with what its board of nursing states.
Accepts the application, holds the license
SSN required to apply
Not stated by the board
Disclaimer: The information provided on this page, including the interactive map, regarding Social Security Number (SSN) requirements for RN licensure, associated fees, and various licensure processes, is intended to assist you in understanding and preparing for the RN licensure requirements in different U.S. states. Please note that RN licensure requirements, fees, SSN prerequisites, and procedural details are subject to change and may vary by state. We highly recommend that you directly confirm the current and specific requirements with each state where you intend to practice. While Axis Medical Staffing makes every effort to keep this information updated and accurate, we cannot guarantee its completeness or current validity at all times. It’s essential to conduct your own due diligence and consult with applicable bodies to ensure you have the most accurate and relevant information.
Note: Clicking any state opens that state board’s official page on SSN requirements. Individual healthcare facilities retain the discretion to determine the acceptance of candidates without a Social Security Number.
| State | Status | Note |
|---|---|---|
| Alabama | Accepts the application, holds the license | Exam applicants can apply without an SSN. License issued only after a copy of the Social Security card is received. Online endorsement application requires an SSN. |
| Alaska | Licenses without an SSN | Request for Exemption from Social Security Number Requirement (form 08-4372) with proof of foreign citizenship. Single-state. |
| Arizona | Licenses without an SSN | Affidavit Re Social Security Number. Must report SSN within 10 days of getting one. Single-state only. |
| Arkansas | SSN required to apply | "A valid United States social security number is required for individuals applying for licensure." No alternative stated. |
| California | Licenses without an SSN | ITIN accepted in place of SSN. Application is not processed without one or the other. |
| Colorado | Not stated by the board | No statement on any dpo.colorado.gov nursing page. Portal FAQ references "SSN/ITIN" only. |
| Connecticut | SSN required to apply | DPH policy. "Disclosure of the social security number is mandatory." No alternative stated. |
| Delaware | Licenses without an SSN | Attestation questions inside the DELPROS portal. Must report an SSN if one is later issued. |
| District of Columbia | Licenses without an SSN | Social Security Number Affidavit (2025). SSN required before first renewal. ITIN not accepted as a permanent substitute. |
| Florida | Accepts the application, holds the license | "You may apply for licensure before obtaining a U.S. Social Security number. However, you will not be issued a license until proof of a U.S. Social Security number is received." |
| Georgia | SSN required to apply | SSN listed as a required item on every application checklist. No alternative stated. |
| Hawaii | Accepts the application, holds the license | Exam applicants may sit the NCLEX and receive a conditional approval, which is not a license to practice. Endorsement requires SSN. |
| Idaho | Licenses without an SSN | Idaho Code 73-122 process. Requires an SSA letter stating no number assigned plus proof of a work-authorizing visa. |
| Illinois | Licenses without an SSN | ITIN accepted, or Social Security Number Affidavit (IL486-2003). Must report SSN within 10 days of getting one. |
| Indiana | Accepts the application, holds the license | Provisional RN license for applicants without an SSN. Non-practice, 180 days, requires a documented Indiana job offer tied to a work visa. Full license requires SSN. |
| Iowa | Licenses without an SSN | Paper application. Requires a US entry document such as a visa. "Without an SSN you will be issued a single state license." |
| Kansas | SSN required to apply | "All applicants seeking licensure by KSBN, must have a valid social security number to be issued a license to practice nursing." |
| Kentucky | Not stated by the board | SSN language appears only for the multistate license. Nothing for single-state. |
| Louisiana | SSN required to apply | "Social insurance numbers from Canadian Provinces are not accepted." Board says apply after receiving the US SSN. |
| Maine | Accepts the application, holds the license | Application can be submitted with the SSN field bypassed. License issued only after SSN is added. |
| Maryland | Licenses without an SSN | ITIN online, or paper application with Affidavit for Licensure. Issues a "Maryland Only" single-state license. Effective Oct 1, 2023. |
| Massachusetts | Licenses without an SSN | Affidavit route for exam applicants residing outside the US. SSN required within one year. Reciprocity applications are not accepted without an SSN. |
| Michigan | Licenses without an SSN | Social Security Number Affidavit for Licensure uploaded with the application. |
| Minnesota | Licenses without an SSN | Checkbox on the application. "I do not have a US Social Security number at this time but will notify the Board if/when I obtain" one. |
| Mississippi | SSN required to apply | "You will not be able to complete the application without including your SSN." |
| Missouri | Licenses without an SSN | Foreign citizen never issued an SSN and never licensed in another US state may submit a visa or passport number instead. Otherwise license held until SSN. |
| Montana | Licenses without an SSN | "An SSN is not required to receive or renew a license." Attestation inside the application. |
| Nebraska | SSN required to apply | "Providing your SSN is mandatory." No alternative stated. |
| Nevada | Licenses without an SSN | ITIN accepted in place of SSN. No affidavit route. Neither number means not eligible. |
| New Hampshire | SSN required to apply | "A SSN is required to apply for licensure and the SSN must be issued and valid. Pending social security numbers will not qualify. There are no exceptions." |
| New Jersey | SSN required to apply | "You must provide your Social Security number to the Board or Committee. Failure to do so will result in denial/nonrenewal." |
| New Mexico | Not stated by the board | Board publishes a verification procedure for applicants with no SSN, but does not state whether the license is issued before an SSN. Ask the board. |
| New York | Licenses without an SSN | "You are not required to have a social security number." No form or ITIN needed. |
| North Carolina | Accepts the application, holds the license | May take the NCLEX while applying for an SSN. "No license will be issued until proof of the Social Security number is submitted." |
| North Dakota | SSN required to apply | "This is not the same as an Individual Taxpayer Identification Number (ITIN) or a Canadian Social Insurance Number (SIN)." |
| Ohio | SSN required to apply | Board sample application (2021) states SSN is required by state and federal law. No alternative found. |
| Oklahoma | SSN required to apply | "You must provide a Social Security number on the application. This information is mandatory." |
| Oregon | Licenses without an SSN | OAR 851-001-0030. Passport plus work visa, a tax identification number, or another federally issued ID number in place of the SSN. |
| Pennsylvania | Licenses without an SSN | Waiver of Social Security Number Verification Statement (03.2024). ITIN optional. Renewal blocked until an SSN is supplied. |
| Rhode Island | Not stated by the board | No SSN statement on any RN page or in the nursing regulation. |
| South Carolina | Accepts the application, holds the license | May apply with a resident alien registration number. SSN required before the background check is processed and before a license is issued. |
| South Dakota | Not stated by the board | SSN language appears only for the multistate license. Nothing for single-state. |
| Tennessee | Not stated by the board | RN exam and endorsement instructions and the board FAQ contain no SSN language. |
| Texas | Not stated by the board | Board publishes fingerprint instructions "For Applicants Without a Social Security Number" but the issuance rule could not be verified. Ask the board. |
| Utah | Licenses without an SSN | ITIN or A-number in place of SSN. If neither, unexpired foreign passport plus an intent-to-hire letter from a Utah employer. DOPL policy since April 23, 2024. |
| Vermont | Not stated by the board | SSN language appears only for the multistate license. Nothing for single-state. |
| Virginia | Accepts the application, holds the license | Applicants without an SSN may receive a single-state 90-day temporary license and can practice on it. Permanent license issued only after SSN. Revised 11/1/2025. |
| Washington | Licenses without an SSN | Declaration of No SSN (DOH 600-057). "You are not required to have or obtain a Social Security Number to apply for or obtain a license." Single-state. |
| West Virginia | SSN required to apply | "By West Virginia law, we must collect your social security number before we can give you an RN license." |
| Wisconsin | Licenses without an SSN | Form 1051 plus DCF-F-2462 affidavit. Must report SSN at next renewal if obtained. Single-state. |
| Wyoming | SSN required to apply | Foreign-educated checklist requires a copy of the Social Security card. No alternative stated. |
Every license issued without an SSN is a single-state license. No state issues a multistate compact license without one. Several of these states require your SSN before your first renewal. Virginia issues a 90-day temporary license you can work on while you wait. Louisiana and North Dakota state that a Canadian Social Insurance Number is not accepted. New Mexico and Texas publish a process for applicants without an SSN but do not say whether the license is issued before you have one. Ask the board directly, or ask your recruiter.
Verified against each state board of nursing, September 2026.
Step 8: Do Canadian nurses need a Social Security Number to work in the US?
- Details: It depends on the state. Some boards accept your application and issue the license without a Social Security Number, some accept the application but hold the license until you have one, and some require it up front. The map and list above show the current status for each state, and your recruiter helps you pick a first state that fits your situation. You can apply for an SSN after you arrive in the US, and you’ll need one for payroll once you begin working.
Tell us where you want to work and your recruiter will walk you through the fastest licensing path for your situation.
Step 9: How do I finalize my U.S. travel nursing assignment with Axis?
- Once your state license is in hand, your recruiter matches you to an open travel nursing assignment and you complete onboarding, background check, health records, and skills checklists. Axis then issues the employment offer letter you’ll present at the border.
- Estimated Timeframe: 4-6 weeks before the start date
Step 10: How do I apply for my TN1 Visa?
-
You don’t apply for a TN visa in advance. As a Canadian citizen you request TN status at the border or at a preclearance airport, with your passport, your VisaScreen certificate, your state license, and the Axis offer letter, and it’s issued on the spot. TN status runs up to three years at a time and can be renewed. It’s tied to the employer named in your offer letter, so if you ever change agencies you need a new TN before you start. Your spouse and children under 21 can come with you on TD status. They can go to school, they can’t work.
- Border Process: Present your comprehensive documentation to the CBP officer and articulate your intent to engage in U.S. nursing jobs for Canadians under the TN1 visa status.
- What to Bring: Ensure you have your valid passport, VisaScreen certificate, Axis’s employment offer letter, and any additional supportive documents.
- Estimated Timeframe: Typically processed upon entry; anticipate potential wait times.
Step 11: When do I begin my assignment in the U.S.?
-
Your first shift is the start date on your contract, usually within a week or two of crossing the border. Your recruiter stays with you through orientation, housing questions, and every contract after this one.
- Estimated Timeframe: Coincides with your assignment’s commencement date
Jennifer Slatten
Jennifer Slatten is Director of Operations at Axis Medical Staffing and our Canadian Liaison. She works with every Canadian nurse who comes to Axis, personally, from the first call through the NCLEX, VisaScreen, state licensing, TN status at the border, and the first shift. If you’ve read this guide and still have a question about your situation, Jennifer is the one who answers it.
Additional Resources
TruMerit
VisaScreen certification for internationally educated nurses, plus credential evaluation and the current fee schedule.
NCSBN
Licensure guidance from the National Council of State Boards of Nursing, including the Nurse Licensure Compact and links to every state board.
Frequently Asked Questions About
Canadian RNs Working in the US
Can Canadian nurses work in the United States?
Yes. Canadian RNs are eligible to work in the US through the TN1 visa pathway. You’ll need a degree from an accredited nursing school, an active Canadian RN license, a passing NCLEX-RN result, a VisaScreen certificate, and a license from the state where you plan to work. Axis provides the TN1 support letter once you accept an assignment.
How long does it take for a Canadian nurse to get licensed in the US?
Plan for three to four months. The VisaScreen is the longest single step, and almost all of that time is waiting for schools and regulators to send your documents, which TruMerit reports takes about 14 weeks on average. Once your documents are in, most certificates are issued within a few business days. Your state license application can run at the same time, and most state applications stay open for up to a year. Requesting your transcripts and license verifications on day one is the single best way to shorten the timeline.
Do I need a Social Security Number to apply for a US RN license?
Not in every state. Nineteen states plus DC issue an RN license without one, using an affidavit, an ITIN, or a visa or passport number instead. Eight more accept your application and hold the license until your SSN arrives. Fourteen require an SSN to apply. The list above shows each state.
Do Canadian nurses need a Social Security Number to work in the US?
Not to get started. Some state boards will issue an RN license without a Social Security Number, and our recruiters can point you toward states that make licensing fast for Canadian RNs. You can apply for an SSN after you arrive in the US, and you’ll need one for payroll once you begin working.
Do Quebec-educated nurses need an English proficiency test?
Only in one case. The VisaScreen includes an English proficiency requirement, but it’s waived if you completed your education in English. If your education was completed in French in Quebec, plan on taking an approved English proficiency exam as part of your VisaScreen application, and note that TruMerit does not accept at-home versions of those exams.
How long does TN status last, and can I renew it?
Up to three years per admission, renewable in three-year increments for as long as the job stays temporary and you still qualify. Many Canadian travel nurses work in the US for years on consecutive TN admissions.
Can I get a multistate compact license while I still live in Canada?
No. A multistate license through the Nurse Licensure Compact is tied to your primary state of residence, and a primary residence outside the US doesn’t qualify. Compact states will still issue a single-state license if you meet their requirements, which is what most Canadian RNs start with. If you later make a compact state your legal home, you can apply for multistate.
Do Canadian RNs have to take the NCLEX to work in the US?
Yes, a passing NCLEX-RN result is required for US licensure. The good news for most Canadian nurses is that every province except Quebec adopted the NCLEX-RN as its licensing exam in 2015, so if you graduated after that outside Quebec you’ve already passed it and can move straight to the next steps. If you licensed before 2015 or trained in Quebec, you’ll need to take the NCLEX-RN at a Pearson VUE test center before applying for a state license.
What is a TN1 visa and how long does it last?
The TN1 is the work visa that lets Canadian professionals, including RNs, work in the US. You can pre-apply online up to seven days before arrival or apply at any CBP port of entry with your Canadian passport, VisaScreen certificate, and the TN1 request letter from Axis. It’s valid for up to three years and can be extended in three-year increments indefinitely, as long as each stay remains temporary in nature. Because the visa is tied to Axis rather than one facility, you can take assignments in any state or facility Axis staffs.
Can my RN license application be processed without an SSN?
In most states, yes. Only fourteen states refuse to process the application without one. In the rest, you can apply now and either receive the license outright or receive it once your SSN is issued. Every license issued without an SSN is single-state.
Can Canadian travel nurses bring family with them to the US?
Yes, TN1 visa holders can bring dependents. You’ll need proof of each dependent’s Canadian citizenship, proof of their relationship to you, and proof that you’re maintaining your own visa status. Build the extra documentation into your timeline so the whole family clears the border together.
Can Canadian permanent residents get a TN visa?
No. TN status is for Canadian and Mexican citizens only. A Canadian permanent resident who holds another citizenship needs a different US work authorization, and that’s a conversation to have before starting the licensing process.
What happens to my TN if I switch travel nursing agencies?
Your TN is tied to the employer named in the offer letter you presented at the border. A new agency means a new TN, at the port of entry or through USCIS, before you start the new contract. Working for a new employer on the old TN isn’t allowed.
Talk to Jennifer, our Canadian Liaison
A dedicated point of contact who guides Canadian nurses through every step, from licensing to your first assignment.
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