Can registered nurses and nurse practitioners inject Botox and fillers in North Carolina?

Yes, under physician delegation; RN must work under a physician's standing orders or protocols. NP/PA may inject under physician collaboration agreement; some independent authority permitted depending on practice setting.

North Carolina · Moderate

Can RNs and Nurse Practitioners Inject Botox in North Carolina?

Nurses do most of the injecting in this industry — but North Carolina 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)

Yes, under physician delegation; RN must work under a physician's standing orders or protocols.

Nurse practitioners & physician assistants

NP/PA may inject under physician collaboration agreement; some independent authority permitted depending on practice setting.

Supervision & the medical director

Required for RN and LPN injection; physician oversight mandatory.

The exam requirement

Required; in-person or telehealth allowed under certain conditions.

What to verify in North Carolina

Establish a clear physician collaboration or delegation agreement and ensure your medical director is licensed and actively involved in protocol 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 →

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