With the support of federal monies, nursing programs for NPs multiplied.10 By the mid-1970’s, there were more than 500, mostly certificate, programs across the country that were preparing nurses to deliver primary care. Programs gradually shifted from certificate to master’s degree preparation as accrediting bodies increasingly required a master’s degree. By the 1980’s, master’s degree programs far outweighed certificate programs. In response to health care reform in the 1990’s, NP programs are proliferating at an astonishing rate to meet increasing demands for primary care services. As of 1995, 248 programs in the U.S. offer a master’s degree with preparation as a NP. In 1994, 49,000 nurses were employed as NPs