Removing barriers to cross-border practice, the Nurse Licensure Compact (NLC) is an interstate agreement allowing a nurse to have one license and the privilege to practice in other compact states. Implemented in 2000, the NLC fosters public protection and access to care through the mutual recognition of one state-based license that is enforced locally and recognized nationally. Along with a majority of state nurses associations, hospital associations and health care facilities in every state overwhelmingly support the NLC. The NLC includes important patient safety features such as facilitation of the sharing of licensure, investigative and disciplinary action information among member states. Since the NLC’s initial launch, advances in technology and an increasingly mobile nursing workforce and patient population have created the need to break down barriers to interstate practice. Access to care has expanded and telehealth has transformed care delivery and erased geographic boundaries. The NLC has the ability to remove the licensure barrier to telehealth practice for more than 4 million nurses.