Licensure follows the patient
The location that matters for telehealth is generally the patient’s, not yours. Sitting in one state and caring for a patient in Puerto Rico generally means you need authority to practice in Puerto Rico — via compact privilege or a Puerto Rico license. See telehealth: patient in another state.
The law that governs this in Puerto Rico
Caring for a patient located in Puerto Rico is practice in Puerto Rico, so it is Puerto Rico’s own nurse practice act that defines what you may do and the Puerto Rico Board of Nurse Examiners that applies it. That act is Ley para Regular la Práctica de la Enfermería en Puerto Rico, 20 L.P.R.A. ch. 9A (board powers at § 204f).
There is no compact statute to cite for Puerto Rico, which is the substantive point rather than a gap in our research: Puerto Rico has not adopted the compact, so the practice act above is the whole of the law that applies to you here.
Compact status is not the only consideration
Even where a multistate license reaches Puerto Rico, your employer and the Puerto Rico Board of Nurse Examiners may impose additional requirements, and some roles carry their own rules. Compact status answers one question — it is not a blanket authorization to practice remotely.
APRN telehealth is separate
The compact covers RN and LPN/LVN licenses only. If you work as an APRN, your advanced-practice authority is granted state by state and is not carried by a multistate RN license — a point that catches out a lot of remote NP roles.
Why compact privilege does not reach Puerto Rico
Puerto Rico has not adopted the compact. Either way the practical answer for caring for patients located in Puerto Rico is the same today: a multistate license from another state does not authorize it, and you generally need a Puerto Rico license from the Puerto Rico Board of Nurse Examiners. Re-check before a start date rather than assuming — this is precisely the fact that changes.