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Does a med spa in North Dakota need a medical director?

Oversight · part of The Practice Perimeter

The Medical Practice Act itself sets the terms on which a physician assistant may practice. A PA serving a patient located in the state must hold an active North Dakota PA license or be privileged under chapter 43-17.5, and the Board of Medicine sets the rules governing a PA’s conduct, licensure, qualifications and discipline. ⛔ The hard limit is negative rather than positive: a PA is NOT authorized to perform any service that must be performed by someone licensed under chapters 43-12.1, 43-13, 43-15 and 43-28. On the nursing side, a nurse may supervise and delegate nursing interventions, to an individual the nursing chapter exempts under a named subsection. The cosmetology chapter answers the microneedling question in its definitions: esthetics excludes any procedure invading living tissue below the stratum corneum and excludes advanced esthetic procedures; ADVANCED ESTHETICS includes microneedling, nonablative procedures, advanced chemical peels and lancet extractions but not treatment of a medical ailment or ablative procedures; and an advanced esthetician must file proof of board-approved additional training before using microneedling pens, rollers or devices.

Drawn from 10 verified rules in this section · regulatory monitoring, not legal advice

The rest of what North Dakota says on this

Every other rule we have verified under physician supervision & delegation, each linked to its primary source.

  • An individual providing the services of a physician assistant under this chapter to a patient located in this state shall possess an active North Dakota license for physician assistant practice or be privileged to practice in this state under chapter 43 - 17.5.

    N.D.C.C. § 43-17-02.1(1) (Physician assistant — scope of practice) · verified Sep 5, 2026

  • The board shall adopt rules governing the conduct, licensure, fees for licensure and privilege, qualifications, and discipline of physician assistants.

    N.D.C.C. § 43-17-02.1(1) (Board rules govern PA conduct and discipline) · verified Sep 5, 2026

  • Physician assistants are not authorized to perform any services that must be performed by individuals licensed under chapters 43 - 12.1, 43 - 13, 43 - 15, and 43 - 28

    N.D.C.C. § 43-17-02.1(1) (A PA may not perform services reserved to other licensees) · verified Sep 5, 2026

  • A nurse may supervise and delegate nursing interventions to an individual exempt under subsection 13 of section 43 - 12.1 - 04.

    N.D.C.C. § 43-12.1-16.1 (Supervision and delegation of nursing interventions) · verified Sep 5, 2026

  • "Advanced esthetics" means the practice of advanced cosmetic preparations or procedures using the hands or a mechanical or electronic apparatus for esthetic purposes. a. The term includes: (1) Advanced chemical peels; (2) Microneedling; (3) Nonablative procedures; and (4) Extractions using lancets. b. The term does not include: (1) Procedures to treat a medical, physical, or mental ailment; or (2) Ablative esthetic procedures.

    N.D. Cent. Code § 43-11-01(3) (“Advanced esthetics” defined — microneedling) · verified Sep 7, 2026

  • "Esthetics" means the practice of a variety of services to beautify or improve the appearance of the skin. b. The term does not include: (1) Any procedure invading living tissue below the stratum corneum layer of the epidermis by any means; (2) Threading hair removal; or (3) Advanced esthetic procedures.

    N.D. Cent. Code § 43-11-01(12) (“Esthetics” defined — exclusions) · verified Sep 7, 2026

  • In addition to the license requirements for an advanced esthetician, a written application and proof of board-approved additional training and certifications must be made to the board before the use of: 1. Microneedling pens, rollers, or devices; 2. Nonablative devices; or 3. Advanced chemical peels.

    N.D. Cent. Code § 43-11-26.2 (Additional certifications for advanced estheticians) · verified Sep 7, 2026

  • The practice of cosmetology, manicuring, or esthetics is limited to noninvasive care; a cosmetologist, manicurist, or esthetician may not alter, cut, puncture, or damage any living cells, whether superficially or through the use of laser, light, or energy; and certain advanced esthetic services, as determined by board rule, may be limited in scope or required to be performed under the supervision or direction of a physician or physician assistant licensed under chapter 43-17, or an advanced registered nurse licensed under chapter 43-12.1, who is sufficiently trained or certified in the procedure being supervised.

    N.D. Cent. Code § 43-11-27.2 · verified Sep 8, 2026

  • A physician assistant may supervise, delegate, and assign therapeutic and diagnostic measures not involving the use of medical imaging or radiation therapy to licensed or unlicensed personnel.

    N.D.C.C. § 43-17-02.1(2)(c) (Physician assistant — scope of practice) · verified Sep 8, 2026

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← All North Dakota rules and changes · MedSpaRadar is regulatory monitoring and reference, not legal, medical, or compliance advice. Verify against the linked primary source and consult qualified counsel before acting — rules change and turn on your specific facts. Legislative data via LegiScan (CC BY 4.0).