Who can inject
MD/DO, NP/PA with physician collaboration, RN under physician delegation.
Registered nurses (RNs)
Yes, under physician delegation and supervision; specific protocols required.
Nurse practitioners & physician assistants
NP/PA may inject under physician collaboration; independent practice varies by board interpretation.
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.
What to verify in North Carolina
Establish a clear medical director agreement and verify delegation protocols comply with NC Medical Board and Board of Nursing standards.
Primary source: NC Medical Board; NC 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.