I don't know about PA, but I know that alot of VA providers how certifications in NC. It's all going to depend on what the state requirements are. For example... NC has a lower standard for certification levels than VA. You can take a VA EMT- I course and go to NC and work as an I, you just have to get reciprocity. On the other hand, VA won't accept NC EMT-I as the same course, as NC's I program is less than that of a VA EMT-Enhanced. If you are nationally registered on the other hand, you can take the state board for that state that you are trying to get your certification in. Alot of Paramedics from NC (actually, VA residents go to NC to take the Paramedic programs because they are much cheaper), get thier NR, and then take the state boards here in VA and become practacing Paramedics in VA and NC. Several of my friends are or were working in NC as a Paramedic and also either work or volunteer in VA as a paramedic as well. It works the same for EMT-B. I've known a couple NC Paramedics who work in VA as I's. They didn't get thier NREMT-P. Check with the office of EMS in PA to see what they require.