Yes: a nurse practitioner, physician assistant or physician can open a cash-pay telemedicine hormone practice in Nevada, and for nurse practitioners it is one of the more straightforward states in the West. APRNs hold full practice authority with no collaborating physician for Schedule III through V prescribing; PAs still practice under a supervising physician; Nevada recognizes the corporate practice of medicine but channels it through a professional-entity statute rather than aggressive enforcement; and the telehealth law lets a provider-patient relationship begin on a video visit. The gating items are a Nevada license for anyone treating Nevada patients, a Board of Pharmacy controlled-substance registration on top of the DEA registration, a Prescription Monitoring Program check before every initial controlled prescription, electronic prescribing of every controlled drug, and a lab strategy that respects Nevada’s limits on consumer-ordered testing. This is a 2026 planning summary, not legal advice; confirm every point with the Nevada State Board of Nursing, the Nevada State Board of Medical Examiners, the Board of Pharmacy and counsel, because rules change.
Nevada practice authority: who can run and own a telemedicine hormone practice
Nurse practitioners in Nevada
Nevada has been a full practice authority state since Assembly Bill 170 took effect in 2013. An APRN licensed by the Nevada State Board of Nursing under NRS Chapter 632 evaluates, diagnoses, orders tests and prescribes under the nursing license alone, with no collaborating physician, no written practice agreement and no transition-to-practice period for general practice. An APRN who intends to prescribe controlled substances adds a DEA registration, a Nevada controlled-substance registration and a Prescription Monitoring Program account (more on those below).
The one physician tether that remains sits in NRS 632.237: an APRN may not prescribe a Schedule II controlled substance unless the APRN has at least two years or 2,000 hours of clinical experience, or prescribes under a protocol approved by a collaborating physician. Testosterone is Schedule III, so an NP can prescribe it from day one of Nevada practice without any physician involvement; the two-year rule only bites if the service menu includes Schedule II drugs, and a newer NP who wants that option runs a written protocol with a collaborating physician until the hours are met. Confirm the current rules and protocol form with the Board of Nursing.
Practical requirements: an active Nevada RN license plus the APRN license (Nevada is not a Nurse Licensure Compact state, and the 2025 compact bill did not advance), national certification in the role and population focus, and the continuing-education and opioid-prescribing training the Board of Nursing requires each cycle.
Physician assistants in Nevada
Nevada PAs are licensed by the Board of Medical Examiners (with MD supervisors) or the Board of Osteopathic Medicine (with DO supervisors), and as of 2026 both boards still use a supervising-physician model. A 2023 bill, AB 364, set out to replace supervision with collaboration and free PAs with 6,000 hours from a written agreement; the version signed into law kept a PA seat on the Board of Medical Examiners but, as public records and PA-association commentary describe it, the collaboration provisions did not survive. Treat Nevada as a supervision state and confirm the current text of NRS 630.271 and 630.275 with the board.
In practice the supervising physician holds an active Nevada license, files the supervising-physician paperwork with the board before the PA begins, and is responsible for the PA’s medical services. Board regulations require the supervisor to spend part of a day at any location where the PA provides services at least monthly, and allow that presence to be satisfied by telehealth; NRS 630.275 lets supervision itself be performed electronically from inside or outside Nevada. A PA’s controlled-substance authority is limited to the schedules the supervisor may prescribe, so a PA-run hormone clinic needs a supervisor with DEA and Nevada controlled-substance registrations. Board rules also cap how many PAs one physician may supervise (three is the commonly cited figure); confirm with the relevant board before signing a supervisor.
Physicians and the corporate practice of medicine
Nevada recognizes the corporate practice of medicine doctrine, rooted in a 1977 Attorney General opinion that a general corporation may not practice medicine and that physicians practicing in corporate form must use a professional entity under NRS Chapter 89. The doctrine is less litigated than in California or Texas, and many practitioners call the state comparatively permissive, but the professional-entity statute does the real work: under NRS 89.070, interests in a professional corporation or professional LLC may generally be held only by natural persons licensed to render the same service the entity was formed for, and transfers to an unlicensed person are void. NRS 89.055 bars any owner from interfering with the professional judgment of the licensees.
A physician starting a cash-pay hormone clinic typically forms a professional corporation or PLLC owned entirely by physicians (NRS 89.050 lets medicine, osteopathy, chiropractic and psychology combine in one entity). Non-clinician partners, investors or a spouse sit in a separate management services organization, an ordinary Nevada LLC, that supplies marketing, technology, billing and staff under a fair-market-value management agreement; the fee-splitting and control details are where counsel earns the fee.
So who may own the practice?
A physician may own the clinical entity outright. An NP may own a practice built on the nursing license: Chapter 89 defines professional service by reference to any licensed personal service, so an APRN-owned professional entity for nursing services is the usual vehicle, and some NP practices use an ordinary LLC with counsel’s sign-off because nursing is not on the medicine list in NRS 89.050. A PA has no independent practice in Nevada and is not on that list either, so a PA-led clinic generally pairs a physician-owned clinical entity with a PA-owned MSO or an employment arrangement. Nevada publishes no bright-line rule for mixed NP-physician ownership of one entity; have a Nevada health-care attorney set the model in writing before you file.
Nevada telehealth rules for a remote hormone practice
Licensure and patient location. NRS 629.515 is the operative statute: before a provider at a distant site may use telehealth to direct or manage care, render a diagnosis or write a prescription for a patient located in Nevada, the provider must hold a valid Nevada license, and is subject to Nevada law and board jurisdiction wherever the provider sits. The patient’s location governs. A 2023 bill to adopt the Uniform Telehealth Act and register out-of-state practitioners (AB 198) passed both houses in amended form but died without final action, so as of 2026 there is no registration shortcut. Physicians licensed elsewhere have two paths: the Interstate Medical Licensure Compact (NRS Chapter 629A), or the special purpose telehealth license under NRS 630.261 for a physician with a full unrestricted license elsewhere, no disciplinary history and ABMS board certification. APRNs apply to the Board of Nursing directly; the APRN Compact is not operative in Nevada.
Standard of care and the first visit. Nevada statute does not require an in-person examination before telehealth treatment or prescribing. NRS 629.515 says telehealth may not expand a provider’s scope or deliver care in a manner that violates the standard of care, which is the same standard that applies in person. For controlled substances the key text is NRS 639.235: a bona fide practitioner-patient relationship is deemed to exist when the patient was examined in person or by telehealth within the six months before the prescription was issued. A documented video visit with a history, lab review and treatment plan satisfies the state layer; federal telemedicine rules for controlled substances have been extended and revised repeatedly, so confirm the current federal position before the first testosterone prescription.
Informed consent and documentation. NRS 629.515 does not spell out a telehealth consent, but the boards expect office-visit documentation plus a record that care was delivered by telehealth with the patient’s consent. Build a Nevada-specific consent into intake, record the patient’s location at each visit, and keep an in-person referral and emergency plan.
Controlled substances, registrations and the PMP. Testosterone is Schedule III, so each prescriber needs a DEA registration tied to a Nevada practice address and, separately, a Nevada controlled-substance registration from the State Board of Pharmacy under NRS 453.226. The Board’s sequence is: pending CS registration number, DEA registration, Prescription Monitoring Program account, then the permanent CS registration. It renews biennially and expires October 31 of even-numbered years regardless of issue date, and prescribing without it is a category D felony under NRS 453.232. Under NRS 639.23507 (AB 474, 2017) a prescriber must review the patient’s PMP report before an initial prescription for any Schedule II, III or IV drug and at least every 90 days during treatment, which covers every testosterone patient on monthly management. Since January 1, 2022, NRS 639.23535 has required controlled-substance prescriptions to be sent electronically through a Board-approved system, with narrow exceptions that include drugs dispensed by a pharmacy outside Nevada; an EHR with certified EPCS is a baseline regardless.
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Entity options, registered agent and Nevada taxes
Physicians choose between a professional corporation and a professional LLC under NRS Chapter 89, filed with the Nevada Secretary of State; the professional-entity filing asks for proof that the organizers hold the relevant license, which is why the ownership question comes first. An NP practice generally files a professional LLC for nursing services or an ordinary LLC on counsel’s advice; any MSO is an ordinary LLC. Every Nevada entity names a registered agent with a physical Nevada street address and files an initial list of managers or officers at formation. Expect the LLC package (articles, initial list and state business license) to run roughly $425 in state fees, with an annual list and business-license renewal of about $350 each year; professional corporations pay a higher license fee. Treat these as typical 2026 figures to confirm with the Secretary of State.
Nevada has no personal income tax, no corporate income tax and no franchise tax, a real advantage for an owner-operated cash-pay clinic. Two state taxes still apply. The Commerce Tax is a gross-receipts tax on Nevada revenue above $4 million per fiscal year at industry-specific rates well under 1 percent; a new practice is nowhere near it, though confirm whether a return is still required below the threshold. The Modified Business Tax is a payroll tax, currently around 1.17 percent of quarterly wages above a $50,000 exemption, filed with the Department of Taxation once you have W-2 staff. Services are generally not subject to sales tax, but retail supplements need a sales-tax permit. A Nevada CPA should set the calendar.
Labs and pharmacy in Nevada
Nevada is one of the states with a real limit on direct-to-consumer laboratory testing. NRS 652.190 permits a licensed laboratory to examine specimens only at the request of a licensed physician, a person authorized by law to use laboratory findings, or, for any member of the public, a test run on an FDA-approved home-use kit sold without a prescription. A venous hormone panel does not fit the consumer-kit category, so a Nevada hormone practice should plan to order every panel under its own account rather than sending patients to a consumer-ordering site. The clinic orders, the patient walks into a draw site in Las Vegas, Henderson, Reno or Carson City, and results return into the EHR for the video review; rural patients may need a mobile phlebotomy partner. Confirm current lab policies.
The pharmacy detail that trips new practices up is nonresident licensing. A pharmacy outside Nevada that ships prescription drugs to Nevada residents must hold a Board of Pharmacy out-of-state pharmacy license under NRS 639.2328, and the Board licenses out-of-state compounding pharmacies separately under NRS 639.230. In 2021 the Board also began reading NRS 639.100 to require the individual pharmacists who dispense or compound for Nevada patients to hold a Nevada registration, a position industry groups disputed. Ask any compounding pharmacy for its Nevada license number and how it handles pharmacist registration before routing the first prescription, and keep a Nevada-based 503A compounder as a backup.
Nevada at a glance
| Item | Nevada (confirm with the board or counsel) |
|---|---|
| NP practice authority | Full; no collaborating physician; Schedule III–V from day one; Schedule II needs 2 years or 2,000 hours or a collaborating-physician protocol (NRS 632.237) |
| PA model | Supervising physician registered with the Board of Medical Examiners or Osteopathic Medicine; monthly physician presence satisfiable by telehealth; 2023 collaboration bill largely did not pass |
| Corporate practice of medicine | Recognized; physician-owned PC or PLLC under NRS 89; owners must hold the same license; MSO for non-clinical ownership |
| Telehealth registration | None as of 2026 (AB 198 died); full Nevada license required; IMLC for physicians; NRS 630.261 special purpose license; no NLC or APRN Compact |
| In-person exam before prescribing | Not required by statute; bona fide relationship via telehealth exam within 6 months (NRS 639.235); federal controlled-substance rules still apply |
| State controlled-substance registration | Required from the Board of Pharmacy in addition to DEA; biennial, expires Oct 31 of even years; PMP account required |
| PDMP check | Mandatory before initial Schedule II–IV prescription and at least every 90 days during treatment; EPCS mandatory since 2022 |
| Direct-to-consumer labs | Restricted (NRS 652.190); clinic orders every panel |
| State tax | No income or franchise tax; Commerce Tax above $4M revenue; Modified Business Tax on payroll; annual list and business license |
The 12-week Clinic In A Box map applied to Nevada
Clinic In A Box™ is a private, 1-on-1, done-with-you 12-week build led by an operator-mentor who runs active telemedicine clinics in the US, Colombia and Australia. The Nevada items land in the weeks shown.
- Weeks 1–4, Foundation. Niche and patient avatar; ownership model (physician PC or PLLC, NP nursing entity, or clinical entity plus MSO) settled with counsel; entity filed, registered agent named, initial list and state business license done; Nevada license confirmed, IMLC or special purpose license started for out-of-state physicians, supervising physician registered for PAs; the Board of Pharmacy sequence started (pending CS number, DEA, PMP account, permanent CS registration) and NPI; HIPAA framework, BAAs, and an EHR with certified EPCS and Nevada telehealth consent language.
- Weeks 5–8, Operations. Intake and telehealth consent with patient-location capture; the PMP check and 90-day recheck wired into the prescribing workflow; the six-month examination rule built into follow-up scheduling; lab account opened and Nevada draw sites plus a mobile-phlebotomy option mapped; compounding pharmacies vetted by Nevada out-of-state license; cash-pay service menu, subscription option and payment processing live.
- Weeks 9–12, Launch. Patient acquisition for Nevada metros and rural counties (Google Business where eligible, referrals, organic search); soft launch and first patients seen; revenue and retention tracking; a 90-day roadmap including the annual list and the October 31 even-year CS renewal.
By week 12 the practice has a compliant Nevada entity, every registration in place, a configured EHR, lab and pharmacy relationships and its first patients. Read the telemedicine hormone clinic compliance guide for the national layer under these Nevada rules, and how to start a telemedicine hormone clinic for the full sequence. Nevada NPs can start with the nurse practitioner practice startup program page; physicians should read the physician telemedicine practice launch program page. The investment is $10,000 for two hours a week of direct work plus messaging between sessions; details are on the Clinic In A Box™ program page.
Frequently asked questions
Can a nurse practitioner open a telemedicine hormone clinic in Nevada without a physician?
Generally yes. Nevada APRNs have full practice authority and prescribe Schedule III through V drugs, including testosterone, without a collaborating physician. The only physician requirement in NRS 632.237 applies to Schedule II prescribing by an APRN with fewer than two years or 2,000 hours of clinical experience. Confirm the entity structure with counsel and the Board of Nursing.
Does Nevada require an in-person visit before prescribing testosterone by telemedicine?
Nevada statute does not. NRS 629.515 holds telehealth to the same standard of care as in-person care, and NRS 639.235 treats a bona fide relationship as established when the prescriber examined the patient in person or by telehealth within the preceding six months. Testosterone is federally controlled, so the federal telemedicine prescribing rules also apply and have changed several times; confirm the current federal position before prescribing.
Do I need a Nevada controlled-substance registration in addition to my DEA number?
Yes. NRS 453.226 requires every practitioner who prescribes controlled substances in Nevada to hold a biennial registration from the State Board of Pharmacy, and the Board does not treat you as authorized until you have an active CS registration, a DEA registration on file and an active PMP account. It expires October 31 of even-numbered years and requires a Nevada practice address.
Can I treat Nevada patients from another state?
Only with a Nevada license; the 2023 bill that would have created an out-of-state telehealth registration did not become law. Physicians licensed elsewhere can use the Interstate Medical Licensure Compact or apply for the NRS 630.261 special purpose telehealth license if board certified with a clean record. Nevada is not in the Nurse Licensure Compact, so APRNs need Nevada RN and APRN licenses; PAs need a Nevada license and a registered Nevada-licensed supervising physician.
Request your free info session
The next step is a free 30-minute info session covering your credential, your Nevada licensing and registration situation, your timeline and whether this is the right vehicle. Call 844-734-2112 or use the form below.