Who can inject
MD/DO, NP/PA with physician collaboration, RN under physician delegation.
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.
The exam that makes it legal
Required; in-person or telehealth allowed under certain conditions. 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; however, physician-approved protocols and delegation documents are essential.
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.