How to Open a Nurse-Owned Practice in Michigan

You've done the math in your head more than once. A few injectable appointments on your day off, on your own schedule, in your own space, and suddenly the shifts you pick up out of obligation start to look optional. Michigan is two markets in one state: the Detroit suburbs and Grand Rapids, where patients already budget for tox, and everything north of Midland, where a nurse who opens in Traverse City can be the only injector for an hour in any direction. (Already run your own practice? Skip ahead, there's a section below built specifically for you.)

The thing that stops most nurses in Michigan was never the clinical work. You already do harder things on a Tuesday than a first tox or IV appointment will ever ask of you. What stops people is everything around it, the ownership rules, the medical director, the setup, all sitting there as one giant undefined to-do. So let's take it in order, starting with the question every Michigan nurse asks first.

Can a nurse own an aesthetics, wellness, or functional health practice in Michigan?

Yes, with the right setup. Michigan's corporate practice of medicine doctrine comes from Attorney General opinions, OAG No. 2451 (1956) and OAG No. 6770 (1993), the latter saying it exists "to prevent laypersons from commercializing the practice of medicine." The mechanics live in the PLLC Act. A professional LLC providing services under the Public Health Code must have "all members and managers of the company" licensed "to render the same professional service" (MCL 450.4904(2)). Nursing is licensed under that code, so an RN can own a nursing entity, and physicians may only share a PLLC with other physicians, osteopaths, chiropractors, podiatrists, or physician assistants (MCL 450.4904(3) and (4)). Nurses aren't on that list.

The Michigan rule that catches almost everybody

Michigan is where the "get an NP as medical director and skip the physician" plan falls apart. There's no full practice authority. A nurse practitioner prescribes nonscheduled drugs on their own (MCL 333.17211a) and controlled substances only as a delegated act of a physician (MCL 333.17076), so a physician's name goes on the paperwork either way. The State Bar of Michigan's 2022 scope-of-practice paper reads diagnosis and ordering labs as outside an APRN's independent scope, and says nurses can't hold equity in a PC or PLLC alongside physicians. So the shape Michigan health lawyers describe is a nurse-owned entity, a physician-owned entity, and a contract between them, which, yes, is two sets of books. No specific Five Square structure for Michigan exists yet.

Does the medical director have to be in the building?

This part works in your favor. A licensee may delegate acts within their scope to a qualified licensed or unlicensed person, performed "under the licensee's supervision" (MCL 333.16215(1)). Supervision is defined, and it never says on site: "the continuous availability of direct communication in person or by radio, telephone, or telecommunication," a licensed professional available "on a regularly scheduled basis to review the practice," and predetermined procedures and drug protocols (MCL 333.16109(2)).

The initial patient evaluation in Michigan

Michigan doesn't use the phrase good faith exam anywhere in the Public Health Code. Say the initial patient evaluation, which some states call a good faith exam. A prescriber acting within scope may prescribe through a telehealth service, with a duty to refer for geographically accessible care and to be available for follow-up (MCL 333.16285), and nothing requires an in-person visit first. What no Michigan primary source says is who specifically must perform the evaluation before a cosmetic injection.

One that surprises people: the LLC annual statement fee is $25 today and drops to $15 after September 30, 2027, written right into the statute (MCL 450.5101).

How Five Square actually gets you started

The whole thing lives in one place: the free Five Square Nurses app. Your medical oversight, the step-by-step training, your pharmacy and vendor accounts, and the entire community of nurse business owners are all in there. You can open it between patients, on a lunch break, or on the couch at 9pm, and pick up right where you left off.

When you join, you're not handed a login and wished good luck. There's a Getting Started path that puts the order of operations right in front of you, so the mountain becomes a checklist.

You pick your lane, or combine them. Five Square supports three:

• Aesthetics. Tox and dermal filler, the core of a nurse-injector practice, with room to add more as you train.
• Wellness. IV therapy and vitamin injections. Low startup, very mobile-friendly, and a natural add-on to aesthetics.
• Functional Health. Peptides, lab work, and whole-person care for nurses who want longer-term, relationship-based patients.

You bring the nursing license and the nerve. We bring the medical director, the compliant Michigan setup, the training, member pricing on products, marketing help, and weekly live calls with experts and other nurse owners, so you're never stuck guessing alone.

And every Five Square member, brand new or already established, gets instant on-demand Good Faith Exams for $19.99 each, a price we subsidize because we believe in nurse success. A walk-in can be cleared in about a minute, seven days a week, and the exam paperwork lands right in the patient's chart, which is exactly what a state board wants to see.

You start before you feel ready, and that's the point

Most programs make you wait. Watch every module, sit through every call, and someday you finally see a patient. By then half the people who started have lost momentum. Five Square runs the other way: you start your practice while you're still finishing the training, because the training sticks when there's a real patient on next week's calendar.

Kayla, an ER nurse in North Carolina, had never injected anyone when she joined. She watched the videos, took notes, and set a goal of 30 people in 30 days. Here's the advice she'd give a nurse who's scared to start:

"Believe in yourself, even when you don't know how to do something. Figure it out. The clinical knowledge from your nursing career is more than enough to get started, and there's a community of people around you who want to help. Do it scared."
- Kayla, ER nurse

She launched April 4. Her first month: 46 appointments, 28 good-faith exams, and $10,320 in revenue, run out of a single room inside a salon she'd been a client at for years. That's one real month from one real nurse, not a typical result and not a promise, and your market and hours are your own. The point is she was exactly where you are, never-done-this-before, and she started anyway.

Does it actually work once you launch?

Getting launched is step one. What you really want to know is whether it works after that. Here's the honest picture, numbers included, because income claims in this industry deserve a skeptical read.

Results vary, and they depend on things no membership controls: your market, your hours, how long you've been at it, how consistently you market. As practices mature, some established members report months in the $10,000 to $20,000 range. Individual results vary widely. Some land higher, some lower, and nobody here will promise you a number.

What's more useful is the math underneath, which is public. Neurotoxin appointments bring in $200 to $600. A syringe of filler runs $500 to $800. IV sessions run $150 to $350. Functional health consults run $150 to $300, often with patients coming back monthly. At those prices, two to four appointments a month would cover the $899 membership before product costs, and everything past that is the business growing. Want to see it with your own pricing? Run your numbers in the Five Square membership earnings calculator.

The nurses say it better than a revenue range does:

"Five Square is the reason I was able to launch my career as an aesthetic nurse injector. From setting up my LLC and making sure I'm compliant in my state, to a dedicated medical director, weekly live calls with experts, and a huge network of nurse entrepreneurs, it was the best decision I made."
- Krystle N., 5-star Google review

"I started with Five Square last spring and they've helped me every step of the way. Trainings, weekly meetings, check-ins. An abundance of resources to actually make you successful."
- Kendra P., 5-star Google review

Inside the community, the wins show up in real time. A nurse a few weeks into her launch posted she was already up to eight bookings, nearly all of it from one post in a local mom's Facebook group. Another saw a husband and wife for their good-faith exams in under ten minutes using the same-day exam tool when her director wasn't free. Scroll the forum any week and it's full of small wins like these.

The Google rating sits at 4.8 stars, and the reviews keep naming the same things: the setup help, the medical director, the training, and a team that answers when you're stuck.

Already run a practice in Michigan? There's a membership for that too

Not every nurse reading this is starting from scratch. Plenty of you already run your own practice and already pay for a medical director somewhere. If that's you, a lot of what's above is stuff you sorted out a while ago, and Five Square has a leaner membership built for exactly your spot. Michigan is on the Five Square expansion roadmap, and in most new states the Established Nurse Membership opens first, so if you already run a practice, you're likely first in line.

It's called the Established Nurse Membership. It's $799 a month, month to month, no annual lock. You get a medical director who's actually engaged, a compliant structure in Michigan, vendor and product pricing, the Five Square Nurse Community, and those instant on-demand Good Faith Exams at $19.99 each, a price we subsidize for our members because we believe in nurse success. There's no new-injector training folded in, because you don't need it and shouldn't pay for it. If you ever want the full education stack later, you can add it.

Here's the honest pitch. Most established practices are either paying $1,500 to $5,000 a month for a director who's genuinely involved, or a few hundred for one who signs protocols and disappears, which is its own risk when a board comes asking. For most nurses, $799 all in beats both, on price and on what you actually get. Tell us what you're paying now and we'll show you the side by side. No pitch, just the math.

What it costs, and the catch nurses look for

For a nurse starting out, membership is a flat $899 a month for one tier, $1,199 for two, $1,499 for all three, on a 12-month term. Startup beyond that is lighter than people expect: a starter tox order, insurance that runs well under most nurses' guesses, and the products you actually use. No revenue share, ever. (Already have a practice? The Established Nurse Membership above is $799 a month, month to month.)

That's usually the moment the skeptical part of your brain asks where the catch is. Fair. So, plainly: you own your practice and your patients through your own LLC. Five Square does not take a cut of what you make, and if a discovery call turns up that the honest answer for you is 'not yet' or 'start smaller,' the team will tell you that too.

Michigan-specific costs to budget for

Articles of Organization for a Michigan LLC are $50 with LARA's Corporations Division, and the annual statement is $25 through September 30, 2027, then $15 after that (MCL 450.5101). If your entity is a professional limited liability company, expect a different annual filing than a standard LLC and confirm the fee with LARA before you budget. Michigan sales tax is a flat 6% on tangible personal property sold to the final consumer, with no local add-ons, so retail skincare is simple to price statewide. You'll register with the Department of Treasury to collect it.

So, where do you actually start in Michigan?

You book the call. That's genuinely it. Not a six-month research project, a 15-minute conversation about your license, your goals, and what launching (or leveling up) in Michigan would look like for you. Whether you're brand new or already running a practice, the whole reason Five Square exists is so you're not doing the hard parts alone.

Schedule a discovery call

Common questions about starting a practice in Michigan

Can an RN and a physician co-own a PLLC in Michigan?

No. A Michigan PLLC rendering services under the Public Health Code must have every member and manager licensed to render the same professional service (MCL 450.4904(2)), and the only cross-license combinations the statute allows are physicians, osteopaths, chiropractors, podiatrists, and physician assistants (MCL 450.4904(3) and (4)). Nurses aren't on that list. The structure Michigan health lawyers describe is a nurse-owned entity and a physician-owned entity linked by contract.

Does my medical director have to be physically present in Michigan?

The statute doesn't require it. Delegated acts happen under "supervision" (MCL 333.16215(1)), and supervision is defined as continuous availability of direct communication in person or by phone or telecommunication, a licensed professional available on a regularly scheduled basis to review the practice, and predetermined procedures and drug protocols (MCL 333.16109(2)). Written protocols and a director who actually answers the phone are the statutory minimum, so pick one who does.

Is a Michigan nurse practitioner independent?

Not fully. An NP can prescribe nonscheduled drugs without delegation (MCL 333.17211a), and controlled substances only as a delegated act of a physician under written authorization (MCL 333.17076). The State Bar of Michigan's 2022 white paper also reads diagnosis and ordering labs as outside an APRN's independent scope. There's no statutory collaborative agreement requirement, though Medicare and Michigan Medicaid expect one. In practice an NP director in Michigan comes with a physician in the paperwork.

Can a registered nurse own a med spa in Michigan? Yes, with the right setup. Michigan's corporate practice of medicine doctrine comes from Attorney General opinions, OAG No. 2451 (1956) and OAG No. 6770 (1993), the latter saying it exists "to prevent laypersons from commercializing the practice of medicine." The mechanics live in the PLLC Act.

Do I need a medical director for aesthetics in Michigan? Yes. Michigan requires oversight for medical aesthetic services, and every Five Square practice includes a medical director as part of the membership.

Can a nurse do Botox in Michigan? Yes, within a compliant structure and with the physician oversight Michigan requires. The clinical work is rarely the barrier; the structure around it is.

I already run a practice in Michigan. Can Five Square still help? Yes. The Established Nurse Membership is built for nurses who already have a practice: $799 a month, month to month, with a medical director, a compliant structure, vendor pricing, and $19.99 on-demand Good Faith Exams. No new-injector training you don't need, and no annual lock.

How much are Good Faith Exams? For Five Square members, simple Good Faith Exams are $19.99 each, on demand, seven days a week, a price we subsidize because we believe in nurse success. One exam can clear a patient for several treatments at once, and the documentation attaches right to the patient's chart.

Is Five Square available in Michigan yet? Michigan is on the Five Square expansion roadmap, and in most new states the Established Nurse Membership opens first. The fastest way to get the timeline and hold your spot is a discovery call.

How much does it cost to start? For a new nurse, membership is $899 a month for one tier, and startup beyond that (a tox order, insurance, products) is lighter than most nurses expect. If you already run a practice, the Established Nurse Membership is $799 a month, month to month. No revenue share either way.