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A survey of advanced practice nurses in the Association of Pediatric Gastroenterology and Nutrition Nurses (APGNN) was conducted to assess role diversity in anticipation of sharing these results with our international colleagues at the World Congress in 2004. A single-page, 14-item survey was sent via e-mail or fax to 79 APGNN advanced practice nurses identified by their credentials (MS, PNP, FNP) in the membership database. Forty surveys were returned via e-mail or fax for an overall response rate of 51%. Most reported working full time as nurse practitioners in an outpatient gastrointestinal clinic, yet almost one third were hospital based. Additional job titles included clinical nurse specialist, researcher, and case manager or clinical coordinator. Slightly more than one half reported seeing any patients in their outpatient practice, whereas 43% saw specific populations, with constipation, gastroesophageal reflux, and abdominal pain being the most common diagnoses. Seventy percent had prescriptive privileges. Billing practices were the most diverse, with 30% always billing under their own number, 23% sometimes billing under their own number, and 40% never billing under their own number (5% not applicable). Overall, most advanced practice nurses in APGNN are pediatric nurse practitioners with a primary focus on outpatient care but also are involved in patient and family teaching, nutrition support, home care, and research. Only a few were involved with procedures, which may be surprising to our adult counterparts.