Objective: To determine whether the disparities in access to care observed within pediatric populations along the lines of race/ethnicity, socio-economic status, and geography are mirrored in student access to school nursing services. Method: Using school district employment records we linked 1,346 nurses to 1,141,495 students working in 296 districts within Washington state in the 2019-2020 school year. We constructed a measure of access (the student-to-nurse ratio) as the log transform of the total number of nursing full time equivalents divided by the total student enrollment within the district, and regressed these against a district's racial/ethnic composition, a measure of socio-economic status (percent eligible for Free-or-Reduced-Price-Lunch), and geography i.e. how urban vs rural. Results: A 1% percent increase in the student population that is Black is associated with a 3.7% reduction in the student-to-nurse ratio, while a 1% increase in the percent of students eligible for Free-or-Reduced-Price-Lunch is associated with a 1.1% increase in the student-to-nurse ratio. Relative to urban districts, rural districts have higher student-to-nurse ratios, but due to the sorting of students to districts by race/ethnicity, when controlling for race/ethnicity results are insignificant. Conclusions: Disparities in access to school nursing services mirror access gaps for pediatric care along socio-economic status and geography. The increased number of nurses working in school districts with more racial/ethnic minority students may play a protective role and partially ameliorate access gaps for these students observed in pediatric primary care. Policy Implications: We provide a framework for how states, absent of centralized data collection on the school nursing workforce, can use existing employment and licensing data to understand where school nurses work, and who has access to them. States should develop their school nurse workforce data in order to aid in resource allocation decisions. To address disparities in access for poorer districts, a reconsideration of state funding formulas that overly rely on local education dollars for school health services may be warranted.