Whether a nurse can open a med spa depends on your state and on whether you are an RN, a nurse practitioner (NP/APRN), or a non-medical owner, because those three roles are treated very differently. Many states apply a corporate practice of medicine (CPOM) doctrine that blocks a nurse from owning the clinical side directly, so the common workaround is a management services organization (MSO) where the nurse owns a management company and a physician owns the medical entity.
Informational, not legal advice
Laws vary by state, change frequently, and depend on the specific services you plan to offer. Nothing on this page substitutes for advice from a licensed healthcare attorney in your state.
The terms, in plain English
A handful of labels come up throughout this guide. Here is what each one means.
- RN, a registered nurse. A licensed nurse. Of the three roles here, an RN faces the tightest ownership limits.
- NP or APRN, a nurse practitioner (advanced practice registered nurse). A nurse with advanced training who, in many states, can diagnose, treat, and prescribe. An NP usually has more ownership options than an RN, but is still limited in many states.
- CPOM, the corporate practice of medicine. A rule that restricts who may own or control a medical practice. In many CPOM states ownership is limited to physicians or other specifically permitted licensed professionals.
- FPA, full practice authority. An NP's right to practice without a physician agreement. It covers clinical work, not business ownership, and it does not cancel CPOM.
- MSO, a management services organization. The company that runs the non-medical side of the business. This is the part a nurse or an investor can usually own.
- PC, a professional corporation. A professional corporation used for the clinical side of a practice. Who may own it depends on state law.
Can a nurse own a med spa?
The short version: it depends less on the word "nurse" than on your exact license and your state. Three separate questions get mixed up, so it helps to take them one at a time.
Who is allowed to own the medical side. In CPOM states, only a physician, or in some states a few named licensed professionals, may own or control the medical practice. Some of these rules are written into law; others come from old court cases or attorney-general opinions, which makes them softer and more situation-specific. Where a nurse cannot own the medical side, the usual fix is to split the business in two: a physician owns the medical company, and the nurse owns a separate management company, the MSO.
Whether the NP has full practice authority (FPA). FPA is the right to diagnose, treat, and prescribe without a physician agreement. It is about clinical work, not ownership. An NP can be fully independent clinically and still not be allowed to own the medical company in a CPOM state, because FPA does not cancel CPOM. FPA also does not automatically cover aesthetic or cosmetic treatments; several states limit independent practice to primary or behavioral care.
Which role you actually hold. RN, NP/APRN, and non-medical owner are three different legal categories, and each is treated differently. The cards below show how, and the state table further down answers the question role by role, not with a single yes or no.
So can a nurse open a med spa on her own? It depends on the state, and it is not always a yes or no. In a state with no broad CPOM rule, direct ownership may be possible, but professional-entity and service-specific rules can still apply. In a CPOM state she cannot own the medical company, but she does not have to take a physician on as a co-owner either: the usual setup is that she owns the management company (the MSO) outright, a physician owns the medical company, and a contract ties the two together. And separately from ownership, many aesthetic treatments such as injectables and lasers still need a physician involved in the care itself, through supervision or a good-faith exam, even where a nurse owns the business.
An RN faces the tightest ownership limits
In most CPOM states a registered nurse cannot own the clinical entity at all. A common path is to own an MSO that handles non-clinical operations while a physician owns the medical side.
An NP/APRN can sometimes own more than an MSO
In some states an NP/APRN may own a nurse-scoped professional entity (for example a Professional Service Corporation or PLLC), which is not the same as owning a Medical Corporation and is highly state-specific.
A non-medical investor is treated differently again
A rule that lets an NP/APRN own a nurse-scoped entity does not mean a layperson can. Lay owners are usually confined to the MSO in CPOM states.
The bottom line: because these three roles are treated so differently, a single yes-or-no answer to "can a nurse own a med spa" is misleading.
What physician involvement can a med spa require, and when?
The takeaway: there is no single national rule, and even states that let a nurse own a med spa can still require physician oversight for specific procedures.
Depending on the state and the services offered, a med spa may need physician ownership, physician supervision, a designated medical director, a pre-treatment medical evaluation, or some combination of these.
Where a medical director is required, the role is not a formality, and state law determines who may serve in it. Often it is a physician who is clinically responsible for the practice, and in CPOM states that same physician usually owns or controls the medical entity and is accountable for patient outcomes. Some states expressly allow another qualified clinician to serve as medical director; Rhode Island, for example, allows a med-spa medical director to be a physician or a certified nurse practitioner. Confirm who may serve in your state.
Where the medical director is a physician, the American Med Spa Association describes that physician's responsibility as being "responsible for each patient that walks through the door of a med spa," including a duty to "ensure that proper protocols are in place, oversee treatment plans, and safeguard patient confidentiality." AmSpa also describes the medical director as needing to be available to patients in the event of an emergency. Some states require a medical professional to be onsite for specific procedures, but the trigger is procedure-specific rather than a blanket rule, so confirm the requirement for your service menu.
Pre-treatment (good-faith) exam. Some states require a physician, physician assistant, or advanced practice nurse to perform a good-faith exam before a patient's first treatment: obtain a medical history, conduct an appropriate physical examination, make a diagnosis, and determine a treatment plan. AmSpa guidance calls for re-examination if the patient seeks new treatments, if their health substantially changes, or at minimum annually. Who may perform this exam, and when, is set by each state.
Protocols and oversight. Where oversight applies, the medical director establishes treatment protocols and oversees their execution.
Delegation limits. A medical director may only delegate services they are personally competent to perform, and must assess and document the skills of anyone they delegate to.
What a medical director should not be is a figurehead. A physician who signs paperwork without genuine clinical oversight exposes their license and the practice to significant legal risk.
Because these requirements are so state-specific, treat the "physician oversight / medical director" columns in the table as an orientation, not a checklist. Several of those cells are marked "unclear, verify" precisely because the requirement lives in board guidance or delegation rules rather than a clear med-spa statute.
Which treatments usually need a physician?
The takeaway: this is where "it depends on your state" matters most, so use the pattern below to know what to check, not as a national rule.
As a rough guide, the higher the medical risk of a treatment, the more physician involvement a state tends to require. That involvement can take several forms: a prescription, a good-faith exam before the first treatment, on-site or on-call supervision, or a physician owner or medical director. Who is actually allowed to perform or supervise each treatment is set by your state's medical and nursing boards, so confirm your own service menu locally.
| Treatment | Typical physician involvement (varies by state) |
|---|---|
| Neurotoxins (Botox) and dermal fillers | Neurotoxins such as Botox require a prescription; dermal fillers are regulated medical devices. Both generally require an appropriate medical assessment, while who may prescribe, order, or inject them depends on state law. |
| Lasers, IPL, RF, and ablative resurfacing | Often subject to physician or advanced-practitioner supervision and delegation rules; ablative procedures are generally regulated more strictly than non-ablative ones. |
| Medical weight loss and prescription skincare | Require a prescriber (physician, NP, or PA) and usually a medical evaluation before treatment. |
| Microneedling with RF, deeper chemical peels, sclerotherapy, PDO threads | Often delegated under physician or advanced-practitioner supervision; the exact rule is state-specific. |
| Facials, superficial peels, microdermabrasion, waxing | Usually performed by an esthetician, with no physician required. |
How does an MSO structure work?
The takeaway: an MSO is a common way for non-physicians to run the business side of a med spa in CPOM states. The structure typically splits the med spa into two separate companies.
One is the medical company, usually a professional corporation (PC). A physician owns it, or in some states the specific licensed professionals the law allows. It employs the clinical staff, delivers and bills for the medical services, and keeps control of every clinical decision.
The other is the MSO, owned by the non-physician (the nurse, entrepreneur, or investor). It runs everything that is not medical and provides those services to the medical company under a written management services agreement. The two companies stay legally separate, and here is roughly what falls on each side.
The medical company (PC): the clinical side
Owned or controlled by a physician in CPOM states. It handles every medical decision: diagnoses, treatment plans, prescriptions, who is allowed to perform each procedure, the medical records, and billing for the medical services.
The MSO: the business side
Owned by the nurse or investor. It handles everything that is not medical: marketing and branding, the lease and premises, hiring and payroll for non-clinical staff, accounting and bookkeeping, scheduling and software, supplies and vendors, and compliance paperwork.
What "own and control the medical company" really means
It is simpler than it sounds, and it is not a franchise the nurse builds and then sells to a physician. From day one there are two separate companies, and each keeps its own owner.
Own means holding the company itself, its shares or membership interest. In a CPOM state a physician holds the medical company, and the nurse holds the management company (the MSO). Neither one buys out the other.
Control means having the final say over the medicine: the treatment protocols, the clinical standards, and who is clinically responsible for patients. In a CPOM state that final medical say stays with the physician.
Day to day it usually looks like this. The nurse runs the business and owns the MSO, which handles marketing, the lease, staff, scheduling, and the money side. The physician owns the medical company and is responsible for the medicine. A management services agreement links the two, and the financial arrangements between the companies must comply with your state's fee-splitting, CPOM, and fair-market-value rules. It is written so the nurse keeps the business she built while the medicine sits legally where the state requires it. The goal is not to hand your business to a doctor; it is to keep the clinical side in the hands the law reserves for a physician.
What the MSO cannot do
The MSO cannot own the medical practice, control clinical decisions, or take a share of revenue in a way that constitutes illegal fee-splitting. AmSpa puts it directly: "In order for the practice to be compliant, the doctor must be in charge of medical and clinical decisions." An MSO that effectively controls the clinical operation risks being treated as a "sham" and voiding the arrangement.
Management fees are commonly structured at fair market value to reduce fee-splitting and control concerns, but the applicable requirements vary by state, and a structure that works in one state may not work in another. Confirm your specific arrangement with a healthcare attorney.
Find your situation fast
This is a quick starting point, not the legal answer. The groups are approximate, and the right answer often depends on your exact role (RN, NP, or non-medical owner). Find your state in the details below and confirm with a healthcare attorney.
States with no broad CPOM restriction: Florida, Idaho, Maine, Missouri, New Hampshire, New Mexico, Ohio, Oklahoma, Wyoming.
States where NP ownership may be available: Arizona, Illinois, Kentucky, Massachusetts, Maryland, Minnesota, Montana, North Dakota, Nebraska, Nevada, Oregon, Utah, Virginia.
States requiring physician ownership or control of the medical side: Arkansas, California, Colorado, Hawaii, Indiana, Kansas, Michigan, Mississippi, North Carolina, New Jersey, New York, Pennsylvania, South Carolina, Tennessee, Texas, Wisconsin, West Virginia.
States that need additional verification: Alaska, Alabama, Connecticut, Delaware, Georgia, Iowa, Louisiana, Rhode Island, South Dakota, Vermont, Washington.
Three cautions carry through every state below:
- Full practice authority is not the same as ownership. An NP can be fully independent clinically and still not be allowed to own the medical company, and FPA does not automatically cover aesthetic treatments.
- The limit is often a company-ownership rule, not a CPOM law. In several states the real barrier is that every owner of a medical company must hold the same license.
- Some rules are softer than others. Where a state's rule comes from an old court case or an attorney-general opinion rather than a clear statute, it is marked "case-law/implied" and is worth confirming locally.
Your state in detail
Tap your state to open the full detail: who may own the clinical entity as an RN, an NP/APRN, or a layperson, the NP practice authority, the physician oversight or medical-director requirement, and the primary source with a link where one is available. A cell marked "unclear, verify" means we could not find a clear official source, so confirm it locally, never assume it.
Research date: 2026-09-05. Source: MedSpaCopy 50-state regulatory sweep, one or more primary or official sources per state where available. Laws change; several 2025-2026 statutes were still being codified at build time. This is for general orientation only. Confirm every state with a licensed healthcare attorney before relying on it. A single cited source usually supports one specific claim, not every claim for that state. This overview covers all 50 states but not the District of Columbia.
States with no broad CPOM restriction
Florida (FL)
Can an RN own the clinical entity? Allowed
Can an NP/APRN own? Allowed
Can a non-medical owner own? Allowed
NP practice authority: Autonomous primary care only, not aesthetics
CPOM basis: No broad CPOM
Physician oversight / medical director: An entity not wholly owned by licensed practitioners that bills third-party payers generally needs a Health Care Clinic License + Medical Director; fee-splitting barred
Primary source: Fla. Stat. § 400.9905; § 464.0123
Idaho (ID)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Full/independent
CPOM basis: No broad CPOM
Physician oversight / medical director: Varies; professional entities rendering medical services owned only by like-licensed professionals
Primary source: Idaho Code § 30-21-901; ISB guidance
Maine (ME)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Full/independent
CPOM basis: No broad CPOM
Physician oversight / medical director: Unclear, verify (medical-director claim is secondary, not statute)
Primary source: 32 M.R.S. § 2102; Board of Licensure 1992 advisory opinion
Missouri (MO)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Allowed
NP practice authority: Restricted (collaborative arrangement)
CPOM basis: No broad CPOM
Physician oversight / medical director: Unclear, verify; no CPOM (Sager v. Lewin, 1907), but medical-direction structure unresolved
Primary source: RSMo § 334.104
New Hampshire (NH)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Full practice authority (plenary prescribing)
CPOM basis: No broad CPOM
Physician oversight / medical director: Unclear, verify; RN-delegated injections require physician exam/delegation
Primary source: N.H. Rev. Stat. § 326-B
New Mexico (NM)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Full practice authority (independent)
CPOM basis: No broad CPOM
Physician oversight / medical director: Varies; 1987 AG opinion permits lay-owned corp employing physicians; laser hair removal under physician supervision
Primary source: N.M. 1987 AG opinion; NMAC 16.10.13 (laser/device use under physician supervision)
Ohio (OH)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Collaborative/supervised (reduced, SCA required)
CPOM basis: No broad CPOM
Physician oversight / medical director: Yes; pain-management clinics must be physician-owned; med-spa "medical director" arises from delegation rules
Primary source: Ohio Rev. Code § 4723.431; § 4729.552
Oklahoma (OK)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Reduced/restricted; conditional independent prescribing after 6,240 hrs (eff. 11/1/2025)
CPOM basis: No broad CPOM
Physician oversight / medical director: Yes; good-faith initial exam required before treatment; unlicensed/esthetician/LPN need direct on-site supervision
Primary source: Okla. Medical Board Med Spa Guidelines (1/18/24)
Wyoming (WY)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Allowed
NP practice authority: Full/independent
CPOM basis: No broad CPOM
Physician oversight / medical director: Unclear, verify; no statutory or case-law CPOM found; Board of Medicine rules contain no ownership restriction; medical-director requirement unclear (secondary sources conflict)
Primary source: Wyo. Board of Medicine Rules; Wyo. Stat. § 33-21-120
States where NP ownership may be available
Arizona (AZ)
Can an RN own the clinical entity? Solo allowed
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Conditional
NP practice authority: Full/independent
CPOM basis: Case-law/implied
Physician oversight / medical director: Varies; ADHS facility license if lay-owned
Primary source: A.R.S. § 32-3230.01 (SB1637, 2022): health professionals may practice in any business entity
Illinois (IL)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Own an APRN professional entity (PSC/PLLC)
Can a non-medical owner own? Prohibited
NP practice authority: FPA by qualification (4,000 hrs + 250 CE)
CPOM basis: Strict
Physician oversight / medical director: Yes; an APRN cannot form a Medical Corporation but may own a Professional Service Corp / PLLC whose owners are APRNs (IDFPR/IDPH memo, Oct 2025); supervision is procedure-specific, delegated ablative laser procedures require on-site physician supervision, while some non-ablative procedures allow physician availability by phone/electronic means
Primary source: 805 ILCS 15 § 13; 225 ILCS 65/65-43; IDFPR/IDPH memo (Oct 2025)
Kentucky (KY)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Prohibited
NP practice authority: Reduced
CPOM basis: Case-law/implied
Physician oversight / medical director: Unclear, verify; charitable/nonprofit providers may be exempt
Primary source: Ky. Rev. Stat. ch. 311
Massachusetts (MA)
Can an RN own the clinical entity? No
Can an NP/APRN own? Solo allowed (after FPA qualifies)
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent after 2+ yrs supervised practice
CPOM basis: Strict (case-law)
Physician oversight / medical director: Varies; McMurdo v. Getter (1937) + c. 156A; fee-splitting limited by c. 175H
Primary source: M.G.L. c. 112 § 80E
Maryland (MD)
Can an RN own the clinical entity? No
Can an NP/APRN own? Solo allowed (NP-scoped entity)
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent
CPOM basis: Strict (statute)
Physician oversight / medical director: Varies; PC stock only to a "qualified person"; FPA CRNP may own an NP-scoped entity; lay involvement via MSO
Primary source: Md. Corps. & Assns. tit. 4; Health Occ. § 14-306
Minnesota (MN)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent (after 2,080 postgrad hrs)
CPOM basis: Case-law/implied
Physician oversight / medical director: Varies; Professional Firms Act limits ownership to qualified professionals
Primary source: Minn. Stat. § 319B.07; § 148.211
Montana (MT)
Can an RN own the clinical entity? No
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Prohibited
NP practice authority: Full practice authority (after transition hours)
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Unclear, verify; MSO permitted; professional-entity shareholders must be same-profession licensed
Primary source: Mont. Code § 35-4-301; Admin. R. 24.156.405
North Dakota (ND)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Conditional
NP practice authority: Full practice authority (independent)
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Unclear, verify; hospitals/nonprofits may employ physicians under contract protecting independent judgment
Primary source: N.D. Cent. Code § 43-17-42
Nebraska (NE)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Conditional
NP practice authority: Full practice authority (after 2,000-hr transition)
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Unclear, verify; professional-corp shareholders/directors/officers must be same-profession licensed
Primary source: Neb. Rev. Stat. § 21-2216
Nevada (NV)
Can an RN own the clinical entity? No
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Prohibited
NP practice authority: Full practice authority
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Varies; FPA NP may own/serve as clinical authority; lay owners only via MSO
Primary source: Nev. Rev. Stat. ch. 89
Oregon (OR)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent
CPOM basis: Strict
Physician oversight / medical director: Varies; allowed, entity structure matters; MSO for admin only (SB 951 bars de facto clinical control); nonprofit/FQHC/rural-health exemptions
Primary source: Ore. Rev. Stat. § 58.503 (formerly § 58.376); SB 951
Utah (UT)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Conditional
NP practice authority: Full/independent (SB 36, 2023)
CPOM basis: No broad CPOM
Physician oversight / medical director: Yes; § 58-67-802 permits practice via any business entity; restriction targets who performs medicine, not who owns
Primary source: Utah Code § 58-67-802
Virginia (VA)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Solo allowed
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent after ~3 yrs/4,500 hrs
CPOM basis: Case-law/implied
Physician oversight / medical director: No; no standalone CPOM statute; professional-corp law deems healing arts + APRNs the same service, so physician+NP co-ownership allowed
Primary source: Code of Va. § 13.1-543; § 54.1-2957
States requiring physician ownership or control of the medical side
Arkansas (AR)
Can an RN own the clinical entity? No
Can an NP/APRN own? No
Can a non-medical owner own? Conditional
NP practice authority: Collaborative/supervised (limited FPA pathway)
CPOM basis: Strict
Physician oversight / medical director: Procedure-specific. For RN-performed aesthetics, Arkansas Board of Nursing guidance requires a patient-specific order from a delegating physician or supervising APRN, with the physician or APRN available in person or electronically during the procedure. A blanket med-spa physician-medical-director requirement was not confirmed. Medical corporation ownership limited to physicians per § 4-29-307; non-physician business ownership via MSO for non-clinical services
Primary source: Ark. Code § 4-29-307 (officers, directors, and shareholders of a medical corporation must be licensed under the Arkansas Medical Practices Act); Ark. Board of Nursing, Role of the Licensed Nurse in the Practice of Aesthetics
California (CA)
Can an RN own the clinical entity? Minority only (up to 49%)
Can an NP/APRN own? Minority only (up to 49%)
Can a non-medical owner own? Prohibited
NP practice authority: Yes, phased (AB 890)
CPOM basis: Strict (statute)
Physician oversight / medical director: Yes; physicians must hold at least 51% of a medical corporation, remaining shares may be held by listed licensed professionals including RNs; no sham control
Primary source: Cal. Bus. & Prof. Code § 2400; Moscone-Knox Act; Medical Board guidance
Colorado (CO)
Can an RN own the clinical entity? No
Can an NP/APRN own? No
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent
CPOM basis: Strict
Physician oversight / medical director: MSO permitted; a PA may be a minority shareholder if physicians keep majority
Primary source: Colo. Rev. Stat. § 12-240-138
Hawaii (HI)
Can an RN own the clinical entity? Minority only
Can an NP/APRN own? Minority only
Can a non-medical owner own? Conditional
NP practice authority: Full/independent
CPOM basis: Case-law/implied
Physician oversight / medical director: Varies; only licensed persons in the profession may hold shares in a medical PC
Primary source: Haw. Rev. Stat. ch. 415A
Indiana (IN)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Conditional
NP practice authority: Collaborative/supervised
CPOM basis: Limited/profession-specific
Physician oversight / medical director: A physician's office is excluded from the med-spa registration framework; how that applies to co-owned or nontraditional practices remains unclear pending implementation/rulemaking. Registration begins Jan. 1, 2027 (SB282, eff. 7/1/2026)
Primary source: Ind. SB0282 (2026)
Kansas (KS)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Prohibited
NP practice authority: Full/independent
CPOM basis: Strict
Physician oversight / medical director: Yes; licensed hospitals may directly employ physicians (St. Francis v. Weiss)
Primary source: Kan. Stat. § 17-2712
Michigan (MI)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Prohibited
NP practice authority: Restricted
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Yes; PC shareholders must be same-profession licensees (MD/DO/chiro/podiatry listed)
Primary source: MCL 450.1284; MCL 333.16215
Mississippi (MS)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Conditional
NP practice authority: Collaborative/supervised (reduced)
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Yes; physician-only medical-entity shareholders; APRN needs collaboration + protocol
Primary source: Miss. Code § 79-10-31/35; MSBML Policy 3.02
North Carolina (NC)
Can an RN own the clinical entity? No (not solo)
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Prohibited
NP practice authority: Unclear, verify
CPOM basis: Strict
Physician oversight / medical director: Yes; NP may co-own with a physician, solo NP ownership not permitted
Primary source: N.C. Gen. Stat. § 55B-14; NCMB position statement
New Jersey (NJ)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Prohibited
NP practice authority: Independent without a joint protocol for qualifying primary/behavioral care after meeting S2996 requirements (P.L.2026 c.6, signed 2026-03-30); the exemption does not apply to elective aesthetic or cosmetic services
CPOM basis: Case-law/implied
Physician oversight / medical director: Unclear, verify; non-physician-owned clinical entities barred; no PLLC
Primary source: N.J. Board of Medical Examiners, ch. 35; N.J. S2996 / P.L.2026 c.6
New York (NY)
Can an RN own the clinical entity? No (MSO only)
Can an NP/APRN own? No, FPA does not override CPOM (MSO only)
Can a non-medical owner own? Prohibited
NP practice authority: Independent > 3,600 qualifying hrs (clinical scope only)
CPOM basis: Strict (statute)
Physician oversight / medical director: Yes; a business not authorized to provide medical/nursing care cannot employ nurses to do so; physician owns the "friendly PC"
Primary source: N.Y. Educ. Law § 6522; § 6902
Pennsylvania (PA)
Can an RN own the clinical entity? No
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Conditional
NP practice authority: Collaborative/supervised
CPOM basis: Case-law/implied
Physician oversight / medical director: Unclear, verify; physician-owned PC/RPC required; hospitals/HMOs may employ physicians
Primary source: 49 Pa. Code § 25.214
South Carolina (SC)
Can an RN own the clinical entity? Only with physician
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Conditional
NP practice authority: Collaborative/supervised
CPOM basis: Case-law/implied
Physician oversight / medical director: Yes; NP/RN entities constrained by physician practice-agreement + physician-only PC shareholding
Primary source: S.C. Code tit. 40, ch. 33
Tennessee (TN)
Can an RN own the clinical entity? No
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Prohibited
NP practice authority: Collaborative/supervised
CPOM basis: Strict (statute)
Physician oversight / medical director: Yes; owners limited to physicians plus podiatrists/chiropractors/PAs; lay via MSO; med spa registration + named medical director mandatory
Primary source: Tenn. Code § 48-101-610; Board rule 0880-02-.20; § 63-6-105
Texas (TX)
Can an RN own the clinical entity? No
Can an NP/APRN own? Only with physician
Can a non-medical owner own? Prohibited
NP practice authority: Delegated/supervised (prescriptive-authority agreement + delegating MD)
CPOM basis: Strict (statute + board rule)
Physician oversight / medical director: Yes; TMB Rule 177.17 describes CPOM and the Medical Practice Act provisions it rests on; non-physician owns MSO only
Primary source: 22 TAC § 177.17; Tex. Occ. Code § 155.001
Wisconsin (WI)
Can an RN own the clinical entity? No
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Prohibited
NP practice authority: Collaborative/supervised transitioning to FPA
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Yes; service-corporation same-field rule requires each shareholder/director/officer be licensed in the same field; NP ownership post-Act 17 (eff. 9/1/2026) unsettled
Primary source: Wis. Stat. § 180.1911; 2023 Act 17
West Virginia (WV)
Can an RN own the clinical entity? No
Can an NP/APRN own? Prohibited
Can a non-medical owner own? Prohibited
NP practice authority: Collaborative, then FPA after 3 yrs
CPOM basis: Strict (statute)
Physician oversight / medical director: Yes; medical corporation needs Board certificate of authorization; shareholders must be physicians/podiatric physicians/PAs
Primary source: W. Va. Code § 30-3-15; § 30-7-15b
States that need additional verification
Alaska (AK)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Conditional
NP practice authority: Full/independent
CPOM basis: No broad CPOM
Physician oversight / medical director: Med-spa medical-director rule not confirmed by a primary source
Primary source: Prof. Corp. Act AS 10.45 (PC shareholders must be like-licensed)
Alabama (AL)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Unclear, verify
NP practice authority: Collaborative/supervised
CPOM basis: Case-law/implied
Physician oversight / medical director: Medical director yes; general business corp may employ physicians if physician keeps independent judgment (1992 board ruling)
Primary source: Ala. Board of Medical Examiners guidance (2-1195)
Connecticut (CT)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Conditional
NP practice authority: Collaborative first 3yr/2000hr, then independent
CPOM basis: Case-law/implied
Physician oversight / medical director: MSO common; PC shareholders must be same-profession licensees
Primary source: Conn. DPH APRN practice guidance
Delaware (DE)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Conditional
NP practice authority: Full/independent
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Professional corp requires licensed-professional shareholders; MSO used for lay involvement
Primary source: Del. Code tit. 8, ch. 6
Georgia (GA)
Can an RN own the clinical entity? Only if licensed
Can an NP/APRN own? Only if licensed and actively practicing
Can a non-medical owner own? Prohibited
NP practice authority: Unclear, verify
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Unclear, verify; shares of a medical PC held only by licensed, actively-practicing professionals
Primary source: O.C.G.A. § 14-7-5
Iowa (IA)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Conditional
NP practice authority: Full/independent
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Yes; physician-wholly-owned dermatology practices exempt from med-spa medical-director rule
Primary source: Iowa Admin. Code 653-13.8
Louisiana (LA)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Conditional
NP practice authority: Collaborative/supervised
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Varies; only physician-owned Professional Medical Corporations may practice medicine; lay corp may employ physicians if it does not control medical judgment
Primary source: La. R.S. § 12:902 (Professional Medical Corporations); La. Board of Medical Examiners CPOM SOP (Dec 2024)
Rhode Island (RI)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Unclear, verify
NP practice authority: Full/independent
CPOM basis: Limited/profession-specific
Physician oversight / medical director: Yes; a med-spa medical director may be a physician or a certified NP; broad CPOM ban is only a proposed 2026 bill, not enacted
Primary source: R.I. Gen. Laws § 23-105-2
South Dakota (SD)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? Unclear, verify
Can a non-medical owner own? Prohibited
NP practice authority: Collaborative/supervised (FPA after 1,040 hrs)
CPOM basis: Strict
Physician oversight / medical director: Unclear, verify; corp may employ physician if independent judgment preserved & no corporate profit from medicine
Primary source: S.D. Codified Laws § 36-4-8.1
Vermont (VT)
Can an RN own the clinical entity? Conditional / unclear, verify
Can an NP/APRN own? Conditional; solo APRN structure may be possible, but interaction with Act 133 requires verification
Can a non-medical owner own? Conditional / unclear
NP practice authority: Full/independent (after 24-month/2,400-hr transition)
CPOM basis: Limited/profession-specific (new 2026 law)
Physician oversight / medical director: Varies; Act 133 (H.583, signed 6/15/2026, eff. 7/1/2026) requires VT-licensed physicians hold majority voting shares/directors for entities employing physicians and practicing medicine; scope over nurse-owned spas unresolved
Primary source: Vt. Act 133 (H.583, 2026); 26 V.S.A. § 1613
Washington (WA)
Can an RN own the clinical entity? Unclear, verify
Can an NP/APRN own? ARNP-owned entity boundaries unclear, verify
Can a non-medical owner own? Conditional, verify (lay: no)
NP practice authority: Full independent (licensed independent practitioner)
CPOM basis: Case-law/implied
Physician oversight / medical director: Unclear, verify; CPOM is case-law (Morelli v. Ehsan, 1988), not codified; 2026 bill 2SSB 5387 FAILED, do not cite as law
Primary source: RCW 18.79; Morelli v. Ehsan (1988)
What can a nurse or NP own vs. what requires a physician?
The takeaway: keeping the three ownership categories distinct clarifies what each license can and cannot hold.
What a nurse can generally own in CPOM states: the MSO, the management company handling branding, marketing, real estate, HR, payroll, billing, and other non-clinical operations. This is a common structure for an RN.
What an NP/APRN can sometimes own beyond an MSO: in some states an NP/APRN may own a nurse-scoped professional entity (for example a Professional Service Corporation or PLLC in Illinois, or an NP-scoped entity in Maryland and several full-practice-authority states). This is not the same as owning a Medical Corporation, and it is highly state-specific.
What a physician typically must own or control in CPOM states: the professional corporation or medical entity that employs clinical staff, bills for medical services, and holds the medical authority. In many CPOM states this entity must be majority- or wholly-owned by a licensed physician; California allows other listed licensed professionals, including RNs, to hold a minority interest up to 49%.
What NP Full Practice Authority covers: clinical independence (diagnosing, treating, prescribing without a physician agreement). FPA is a separate question from business ownership and does not override CPOM. FPA also does not automatically confirm that an NP may independently offer elective aesthetic or cosmetic services; that depends on how each state defines autonomous scope.
The permissive states: in states with no broad CPOM restriction (for example Florida, Idaho, New Mexico, Ohio, Wyoming), a nurse or a layperson can often own the business directly, but physician supervision may still attach to specific procedures, and NP autonomous-practice scope may not reach aesthetics (as in Florida).
The co-ownership middle path: several states (for example North Carolina and Virginia) let an NP co-own a practice alongside a physician but not own one alone.
Legal disclaimer
The information on this page is a general educational overview compiled from publicly available official sources as of 2026-09-05. It is informational, not legal advice. Med spa ownership law varies by state, changes frequently, and depends on the specific services, licensing, and business structure involved. Several statutes cited here were amended in 2025-2026 and may still have been in the process of being codified when this page was compiled. Cells marked "unclear, verify" mean no clear official source was found and must be confirmed locally. No part of this page should be used as a substitute for advice from a licensed healthcare attorney in your state. Before forming a business entity, engaging a medical director, or structuring an MSO arrangement, consult an attorney who practices healthcare law in the relevant state.