It is possible, but more difficult than making FamiTone to work, I'd say. NSF format is not designed for such purpose, you'll have to work around its memory layout and limitations, if there is no sound effects support in a given NSF, then it'll be music only.
You can use the original FamiTracker driver as well, this removes the memory layout issue, but it does not readily support sound effects, and is not designed to be used in games (memory and CPU usage, acceptable for relatively simple games). I'd say it is more difficult than using FamiTone,
MUSE, or some other solution that is specifically designed to be used in games.
For the record, I used all three things in practice: NSF, FamiTracker driver, FamiTone. First two were used for stuff that does not need to play sound effects along the music.