Working as a CRNA in Missouri

Missouri offers substantial opportunities for CRNAs, especially within major health systems such as Barnes-Jewish Hospital / Washington University, St. Luke’s Health System, Mercy Health System, SSM Health, and CoxHealth. CRNAs can work in Level I trauma centers, academic medical centers, community hospitals, and ambulatory surgery centers across both urban centers (St. Louis, Kansas City, Springfield) and smaller regional facilities.

Missouri requires CRNAs to practice under physician collaboration or supervision; independent practice authority is not currently granted. Scope of practice and privileges are determined by hospital credentialing processes and statewide regulatory standards. Many hospitals utilize the Anesthesia Care Team (ACT) model or structured collaborative arrangements to define clinical responsibilities for CRNAs.

With a broad mix of clinical environments — from high-acuity academic centers to rural community hospitals — and consistently strong demand for anesthesia services, Missouri remains a solid state for CRNAs seeking varied practice settings, stable employment, and a clear structure for collaboration with physician-led anesthesia services.

Education and Certification

• Educational Requirement: CRNAs must complete a doctoral degree from an accredited nurse anesthesia program.
• Certification: After graduation, candidates must pass the National Certification Examination (NCE) administered by the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA).

Licensure

• Missouri License: CRNAs must hold a valid Missouri Registered Nurse (RN) license and apply for CRNA certification through the Missouri State Board of Nursing.
• Renewal: The NBCRNA Recertification Process for All Practicing CRNAs .

Scope of Practice

• Autonomy: Missouri does not allow CRNAs to practice independently. CRNAs must be supervised by a licensed physician.
• Prescriptive Authority: CRNAs may be authorized to prescribe medications as part of their practice.

Collaboration

Collaborative Care Model and Anesthesia Care (ACT) Model.

State Regulations

CRNAs should stay updated on any changes in state laws and regulations affecting their practice. For current information, check out the Missouri State Board of Nursing and Missouri CRNA Association .