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Tennessee CRNA License 2026: APRN Requirements, Practice Protocol, Salary

AH
Ava Health Team
··9 min read

Tennessee CRNAs are licensed as APRNs by the Tennessee Board of Nursing. Tennessee is a reduced practice state — a written practice protocol with a collaborating physician is required. Tennessee has NOT opted out of the federal Medicare CRNA supervision requirement. Nashville is headquarters to HCA Healthcare, the country's largest for-profit hospital system, creating one of the most active CRNA job markets in the Southeast. No state income tax on earned wages provides a meaningful take-home advantage.

Practice Model

  • Written practice protocol with supervising/collaborating physician required
  • Tennessee has NOT opted out of federal Medicare CRNA supervision requirement
  • ACT model: Vanderbilt University Medical Center, major HCA facilities in Nashville
  • CRNA-independent (with protocol): Ballad Health (Appalachian region), regional community hospitals, rural CAH facilities
  • No state income tax on wages — significant retention advantage for high-earning CRNAs

Application Requirements

  • Active Tennessee RN license (compact or TN-issued)
  • Current NBCRNA certification
  • Official nurse anesthesia program documentation
  • Completed TN DOH online application + $100 fee
  • Criminal background check

Processing Timeline

Tennessee Board of Nursing processes APRN applications in 6–10 weeks from complete submission. Tennessee does not routinely issue temporary authorization to practice; plan accordingly when negotiating start dates.

CRNA Salary in Tennessee (2026)

MarketAvg CRNA SalaryNotes
Nashville$198,000–$228,000HCA HQ market; Vanderbilt; high surgical volume; no income tax
Memphis$190,000–$220,000Methodist Le Bonheur, Regional One, Baptist Memorial; Level I trauma
Knoxville$188,000–$215,000University of Tennessee Medical Center, Tennova Health
Chattanooga$185,000–$212,000Erlanger Health, CHI Memorial; regional market
Appalachian / Ballad Health region$190,000–$220,000Ballad Health system; CRNA-dependent rural network; recruitment packages

Top Employers in Tennessee

  • HCA Healthcare — Nashville HQ; 20+ TN facilities; largest CRNA employer in the state; both ACT and CRNA-independent models
  • Vanderbilt University Medical Center — Nashville; academic ACT model; Level I trauma; CRNA residency/fellowship
  • Ballad Health — Appalachian TN/VA; CRNA-dependent regional system; 19 hospitals; strong rural CRNA demand
  • Methodist Le Bonheur Healthcare — Memphis; multi-site; CRNA-independent model at community facilities
  • Tennova Healthcare — Knoxville + East TN; community health network

What We See at Ava Health

Tennessee's no-income-tax status combined with Nashville's explosive growth makes it a premier CRNA market. HCA's national headquarters in Nashville creates a concentration of hospital employment that generates steady CRNA demand; HCA facilities operate in both ACT and CRNA-independent models depending on the facility's surgical volume. Ballad Health's Appalachian network (Kingsport, Johnson City, Bristol) has persistent CRNA shortages and actively recruits with competitive signing bonuses and competitive base compensation.

Related: CRNA Salary by State 2026, NP License Tennessee 2026, CRNA License North Carolina 2026.

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