Explore the journey of nephrology nurse practitioners (NPs), tracing their inception in nephrology to the present day. Witness the evolution of their roles across the kidney care spectrum, highlighting diverse responsibilities. Uncover the substantial investments required for hiring, educating, and onboarding these professionals, while also examining strategies for retaining them in these critical roles. Examine state regulatory requirements to discern practice disparities and commonalities. Comprehend the significant financial contributions nephrology NPs can make within various practice settings. Conclude by advocating for the elevation of professionalism in this indispensable role, emphasizing NPs value within health care