ENPs are specialized licensed practitioners, who possess the necessary clinical competencies to provide optimal care to patients in ambulatory, urgent, and emergent care settings. ENP specialization builds upon NP entryinto-practice knowledge and skills and requires a minimum of a master’s level preparation or specialized preparation at the post-master’s or doctoral level. ENPs demonstrate competencies by applying standardized care guidelines in their clinical practice. Other ways of continuing competencies include participation in maintaining continuing education, quality improvement processes and peer reviewsincluding the systematic periodic review of records and treatment planswhile maintaining specialty and population-focused certification in compliance with current laws and regulations.