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In North Dakota, Botox injections are considered medical practice and must be administered by physicians; private practice nurse practitioners if the treatment falls within their scope of practice; a physician assistant working under the supervision agreement; or a registered nurse (RN) under the direction and supervision of a physician if [1] the physician has completed the initial examination of the patient.

An unaffiliated activity If [1] it falls within the NP's field of practice, [2] it is in accordance with the nursing delegation rules, [1] the NP has performed the initial assessment of the patient, and [2] the RN has extensive, advanced, and certified training, qualification, and competencies to safely perform the procedure, the NP may delegate injection of Botox to an RN.