Owning a Medical Spa or Clinic as a Nurse Practitioner
- Justin Marti
- May 8, 2024
- 5 min read
Updated: Jun 24
Can a Nurse Practitioner Own a Medical Spa?
If you're a nurse practitioner (NP) with a passion for aesthetics, you may be wondering: Can I own a medical spa or clinic?
The short answer: Yes—in many states, with the right structure in place. Whether you're looking to start your own aesthetic clinic or buy into an existing practice, understanding the legal and operational framework is critical.
In this guide, we’ll break down the rules around NP ownership, how state laws vary, and what to consider when building a team or expanding services.
Want more information on medical spa ownership? We wrote an entire ebook on the topic: Navigating the Legalities of Medspa Ownership. Download it for free here.
State-by-State Regulations
There are currently 28 states in which a nurse practitioner (NP) can practice independently (that is, without physician oversight). Generally, independent practice status is obtained after some amount of time working in collaboration with a physician. Once granted, the NP can own and operate a practice independently.
Given that states all agree that medical aesthetic services are considered the practice of medicine (perhaps the only thing they agree on), NPs in these states are able to own a clinical entity providing these services.
There are three levels of practice authority for NPs:
Full: NPs can prescribe, diagnose, and treat patients without physician oversight. Nurse practitioners who operate in full-practice states are allowed to establish and operate their own independent practices in the same way physicians do.
Reduced: NPs can diagnose and treat patients, but need physician oversight for certain tasks, such as to prescribe medications.
Restricted: NPs need physician oversight to prescribe, diagnose, and treat patients.
When a state allows an NP full practice authority (see the full list of 28 states here), they can own and operate a medical spa independently. An NP living in a state without full practice authority can still take a quasi-ownership role through an MSO model.
(Learn more about MSOs in our article here.)
Hiring Considerations for NP-Owned Practices
As your practice grows, you’ll need to bring in more hands to handle patient demand. Here are a few considerations for nurse practitioners as they hire and build their teams.
Employees vs. Independent Contractors:
Will you consider your providers and staff employees or independent contractors? There are benefits and challenges to both classifications. For example, hiring employees allows you, the owner, to maintain control over your practice, including setting the schedule and other important decisions. On the other hand, independent contractors offer cost savings for the owner, since you won’t be obligated to provide benefits or equipment.
The most important thing to keep in mind, however, is that the classifications are not arbitrary and are heavily regulated. We wrote an article about the differences between the classifications here.
Hiring a Physician’s Assistant as a Nurse Practitioner
If you plan to add a PA to your practice, they will need to have a Collaboration Agreement in place with a physician. You’ll also need a clear, written Employment or Independent Contractor Agreement. It’s best to have a legal partner review your agreements to ensure compliance.
Non-Competes
If you’re adding non-competes into your employment agreements (common for injectors with a loyal patient following), there are a few things to keep in mind. The Federal Trade Commission (FTC) previously released sweeping reform nationwide, attempting to render non-competes unenforceable. However, the ban on non-competes was blocked by a Texas judge, so they can remain in place for now.
For now, at a federal level and in most states, non-competes remain enforceable if “reasonable.” Reasonableness is a subjective test that measures the geographic scope (how many miles) and duration (how long) of the non-compete language.
Legally Complicated Medspa Services
Some medical spa treatments are straightforward, like injectables or lasers. Others, however, have ambiguous (at best) regulations. Can you offer IV therapy in your practice? What about medical weight loss? Who can administer or prescribe treatments?
That answer, of course, depends on your state. Even if you’re an NP owner in a full-practice authority state, you’ll need to thoroughly understand your state’s guidance on compounding, off-label use, and more. We write extensively on these two services in articles linked below:
Buying a Practice as an NP
Rather than starting a practice from the ground up, NPs may also have the option to purchase an existing practice. This is an excellent path to choose if you can find the right practice, as it comes with a built-in patient bse. There are two primary ways to purchase an existing practice: an asset purchase or a stock purchase. Below, we’ll outline the differences.
Asset Purchase: In an asset purchase, the seller remains the legal owner of the existing (selling) business entity. The buyer (in this case, the NP) forms a new legal entity (think: PC or PLLC), which offers a clean slate and avoids “successor liability” (inheriting debts or outstanding obligations of the seller). The buyer would purchase the assets (the goodwill, equipment, patient lists, inventory, and more) in the name of the newly-formed entity. The downside of an asset purchase for the buyer is that they take on the administrative burden of setting up a new entity and vendor/insurance relationships in the process, but again, the liability limitations may outweigh the costs.
Stock Purchase: In a more straightforward stock purchase, the buyer purchases the business as-is, essentially stepping into the shoes of the seller. It’s a clean continuation of the existing business. Keep in mind that a stock purchase can come with legacy issues, so it’s important to perform due diligence on any business you’re considering acquiring.
For more considerations for medspa practice buyers, check out our article here.
Finally, an MSO model remains a possibility for nurse practitioners who live in states with reduced or restricted practice authority.
Legal Counsel for Nurse Practitioner Owners
If you are an NP and a current (or future) medspa or clinic owner, find legal counsel who can help you start, grow, and even sell your practice. From establishing your legal entity to employment agreements and more, our team understands the ins and outs of medspa ownership and how it varies by state.
Whether you’re starting, scaling, or selling a medical spa, legal guidance is essential. Our team at Marti Law Group specializes in healthcare and aesthetic law, helping NP owners:
Form legal entities
Draft compliant employment agreements
Navigate MSO structuring
Stay current on state law
Reach out to us to learn more about how we can support your practice.
Nurse Practitioner Med Spa Ownership FAQs
Can a nurse practitioner own a med spa?
Yes—in many states with full practice authority. In other states, they can operate through an MSO model.
What’s the MSO model and how does it work for NPs?
An MSO (Management Services Organization) allows NPs in restrictive states to manage the non-clinical aspects of a medspa, while a physician handles clinical oversight.
Is it legal to hire a PA as an NP practice owner?
Yes, but the PA must have a collaborating physician and a written agreement, even if hired by an NP.
Can I offer IV therapy or semaglutide injections as an NP owner?
It depends on state laws and your scope of practice. Consult legal guidance before adding these services.
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