Mark Twain Medical Center

California is not a nursing-licensure compact state, so you need a California RN license to practice here. The state also runs a graduated income tax whose top brackets are among the highest in the country. We do not yet have usable pay ranges, ratio detail, scheduling texture, residency structure, or benefits language tied to this employer. If you move forward, treat the application as the start of a real conversation—ask about the unit you would join, how orientation works, and what support looks like in the first months. Those answers are not in the facts we hold today.