Registered nurses (RNs)

Yes, under physician delegation; specific protocols and supervision requirements vary by board interpretation.

Nurse practitioners & physician assistants

NP/PA may inject under physician supervision; independent practice for injectables not clearly permitted.

Supervision & the medical director

Required for medical spa operations; physician supervision of delegated tasks is mandatory.

The exam requirement

Required; in-person exam generally expected before treatment.

What to verify in North Carolina

Establish a written delegation agreement with a supervising physician and document all protocols for RN/NP/PA injector oversight.

Primary source: North Carolina Medical Board / Board of Nursing

General business information for North Carolina medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the North Carolina board (and your own counsel) before you act.

See the full North Carolina regulation profile →