States’ requirements for APRNs vary. In general, APRNs must have a registered nursing license, complete an accredited graduate-level program, pass a national certification exam, and have an APRN license. Details are available from each state’s board of nursing. To become licensed and use an APRN title, most states require national certification. The National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) offers the National Certification Examination (NCE). Certified registered nurse anesthetists (CRNAs) must maintain their certification through the Continued Professional Certification (CPC) Program. The American Midwifery Certification Board offers the Certified Nurse-Midwife (CNM). Individuals with this designation must recertify via the Certificate Maintenance Program. There are several different certifications for nurse practitioners, including those available from the American Academy of Nurse Practitioners Certification Board (AANPCB), the American Nurses Credentialing Center (ANCC), and the Pediatric Nursing Certification Board (PNCB). Each of these certifications requires periodic renewal.