Who can inject
MD/DO, NP/PA under physician supervision, RN under physician delegation.
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.
The exam that makes it legal
Required; in-person exam generally expected before treatment. A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure; manufacturer training recommended.
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.