CNA Requirements in North Carolina

Becoming a CNA in North Carolina is unique because the state operates a two-tier nursing assistant credentialing system that no other state quite matches. The entry-level credential, Nurse Aide I (NA I), is the equivalent of the standard CNA found in other states and requires the federal-minimum 75 hours of training. The advanced credential, Nurse Aide II (NA II), requires an additional 80+ hours of training and a separate competency evaluation and authorizes expanded clinical skills like sterile dressing changes, catheterization, and certain medication administration. Most CNA pathways in NC start with NA I and add NA II later, after gaining experience, to broaden employment options.

The NA I pathway itself is conventional. Full-time programs at the North Carolina Community College System, the American Red Cross, and private career schools typically run 4 to 6 weeks. The exam vendor is Pearson VUE rather than the more common Prometric or Credentia, and the combined fee is approximately $120 for both the written and skills portions. The NC State Bureau of Investigation criminal background check plus federal FBI fingerprint clearance must clear before you are added to the Nurse Aide I Registry at ncnar.org.

After working as a NA I, many candidates pursue NA II certification through the North Carolina Board of Nursing (a separate regulator from DHSR, which oversees NA I). NA II training is typically offered at community colleges and hospital systems, often as a continuing-education pathway for working CNAs, with tuition in the $600 to $1,500 range. The NA II credential is highly valued by hospitals and some skilled nursing facilities and can meaningfully expand your earning potential. Several NC hospital systems and nursing facility chains sponsor NA II training for current NA I employees in exchange for a work commitment.