Despite substantial clinical acumen, as demonstrated by consistent, high quality outcomes, nurse midwives remain in the background of the primary care setting. Reviews of nursing literature, spanning thirty years, identify recurring knowledge based barriers to private practice and entrepreneurial endeavors among advanced practice nurses. Literature specific to barriers specific to nurse-midwifery entrepreneurialism is markedly limited. The purpose of the proposed Clinical Doctorate Capstone Project was to examine the current knowledge deficit that exits among nurse-midwives related to entrepreneurial practices. This investigation was accomplished using a two-round Delphi panel of successful nurse-midwife entrepreneurs. Inclusion criteria for panel membership were defined as: completion of a nurse-midwifery education program and subsequent entrepreneurial experience within the scope of nurse-midwifery care. A total of ten panel members provided first-hand information on their experiences and entrepreneurial knowledge deficit through a survey tool comprised of open-ended questions. The responses and observations were categorized by theme in order to refine the data and establish consensus. The second round of inquiry solicited clarifications and commentary on the identified themes and resulted in consensus opinions among the panel members on the current entrepreneurial knowledge deficit that exists among nurse-midwife entrepreneurs. This methodology provided clear insight into the specific knowledge based roadblocks experienced by the expert panel members. The Delphi panel input identified several common themes as well as specific knowledge deficits related to entrepreneurial practice among nurse-midwives. These themes and findings correlate to key components of the Entrepreneurial framework and specifically identify knowledge deficits related to opportunity recognition, operationalization, resource identification, fiscal planning and entrepreneurial performance and sustainability. The Delphi panel identified very specific knowledge deficits related to entrepreneurial skills among nurse-midwife entrepreneurs. Consensus was reached regarding knowledge deficits ranging in complexity from elementary entrepreneurial skills, such as the ability to quantify revenue potential for nurse-midwifery practice to more in-depth entrepreneurial business planning. Consensus opinion also identified that early exposure to entrepreneurial nurse-midwives, especially during clinical practicum, facilitated the nursemidwives in identifying entrepreneurial opportunities while simultaneously enhancing confidence related to entrepreneurialism. Suggestions for future research include continuing the evaluation of entrepreneurial knowledge deficit through a Delphi panel of current nursemidwifery students and professional organization membership. Such an evaluation could serve to support and clarify the findings of this Capstone project. It is proposed that the knowledge gained from additional Delphi panel investigation on this topic will serve to enhance evidence-based interventions designed to increase entrepreneurial knowledge and competence among nurse-midwives.