Who can inject
MD/DO, NP/PA with physician supervision, RN under physician delegation
Registered nurses (RNs)
Yes, under physician delegation; specific training/protocols required
Nurse practitioners & physician assistants
May practice with physician supervision; independent practice limited
The exam that makes it legal
Required; in-person or telehealth allowed for established patients 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.
What to verify in Missouri
Confirm your medical director's scope and ensure written delegation protocols for all injectors are documented and board-compliant.
Primary source: Missouri State Board of Nursing and Missouri State Board of Registration for the Healing Arts
General business information for Missouri medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Missouri board (and your own counsel) before you act.