It's fairly common for a user to wear multiple hats in the practice. For example, a practice manager is also a nurse practitioner. How do you manage that in the system? 

First, there is no need to create multiple user roles in the system. You can combine the roles as one and name it accordingly. For example, you can name it as "Practice Manager & Nurse Practitioner" or simply rename the "Practice Manager" user role because it has more access than the "Nurse Practitioner" user role.  

In short, the user role is for managing menu access in the system. The ability to do e-prescribing is set in user accounts and is not affected by how you set up the user role. Other abilities such as scheduling providers, encounter access, and messaging support are defined by user groups.