Can registered nurses and nurse practitioners inject Botox and fillers in Virginia?

Limited; RN may inject only under direct physician supervision on-site NP/PA may inject under physician collaboration agreement; independent practice restricted

Virginia · Strict

Can RNs and Nurse Practitioners Inject Botox in Virginia?

Nurses do most of the injecting in this industry — but Virginia draws specific lines around what an RN versus an NP can do, and who has to supervise.

By Evan at Inside MedSpa

Registered nurses (RNs)

Limited; RN may inject only under direct physician supervision on-site

Nurse practitioners & physician assistants

NP/PA may inject under physician collaboration agreement; independent practice restricted

Supervision & the medical director

Required; physician must be actively involved in oversight

The exam requirement

Required; in-person examination mandatory

What to verify in Virginia

Ensure a Virginia-licensed physician is actively involved in ownership or management and confirm direct on-site supervision requirements for all injectors before opening.

Primary source: Virginia Medical Society; Virginia Board of Medicine; Virginia Board of Nursing

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

See the full Virginia regulation profile →

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