Nurse Practitioner Salary in Tennessee (2026)
The average Nurse Practitioner in Tennessee earns around $125,000/year. After taxes, your estimated take-home is $96,704/year ($8,059/month).
Take-Home Pay Breakdown
| Category | Amount |
|---|---|
Annual Take-Home Pay | $96,704 |
Monthly Take-Home Pay | $8,059 |
Biweekly Take-Home Pay | $3,719 |
Hourly Take-Home Pay based on 2,080 hrs/year | $46/hr |
Federal Tax | $18,734 |
State Tax | $0 |
FICA Taxes | $9,563 |
Effective Tax Rate total taxes ÷ gross salary | 22.64% |
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Nurse Practitioner Salary Ranges in Tennessee
Not all Nurse Practitioners earn the same — not even close
TN nurse practitioner roles split across academic-medical (Vanderbilt University Medical Center, St. Jude Children's), HCA-affiliated regional hospitals (HCA HQ Nashville with ~50 TN hospitals), Methodist Le Bonheur (Memphis), UT Medical Center (Knoxville), Erlanger (Chattanooga), Covenant Health, plus ambulatory + telehealth + private specialty (psychiatry, dermatology aesthetics, primary care). Vanderbilt School of Nursing (top-10 US graduate nursing program), University of Tennessee Health Science Center (Memphis), East Tennessee State University, Belmont University, and Tennessee State University produce the in-state APRN pipeline. APRN Compact (TN implementing) for emerging interstate practice mobility.
Family Nurse Practitioner (FNP, primary care)
$98,000-$118,000
HCA-affiliated primary care + ambulatory · TN reduced-practice-authority
Acute Care NP (Vanderbilt / HCA)
$118,000-$148,000
ICU / cardiac / post-op · academic-medical premium · Vanderbilt Magnet
Adult-Gerontology AGNP
$108,000-$128,000
Ambulatory / specialty / hospitalist
Psych-Mental Health (PMHNP)
$118,000-$155,000
Vanderbilt psych + Centerstone + telepsych private · TN telepsych rapidly expanding
St. Jude Children's NP (Memphis)
$118,000-$155,000
St. Jude pediatric oncology · NCI-Designated Comprehensive · top US pediatric NP market
Aesthetic NP (Botox / fillers)
$135,000-$215,000
Williamson County / Memphis Germantown high-end medspa · revenue share
CRNA (Nurse Anesthetist)
$185,000-$265,000
Vanderbilt + HCA + Methodist + Erlanger + ambulatory surgery centers
Telehealth NP (Tennessee residency, multi-state)
$115,000-$165,000
NLC + APRN compact · serve multi-state via telehealth · 0% TN residency
Worth knowing: Tennessee is a REDUCED-PRACTICE-AUTHORITY state — NPs require a written collaborative practice agreement with a physician for prescribing authority and certain clinical decisions. This is similar to MD, IN, and the opposite of MA's full-practice authority (since 2021). The collaborative-practice-agreement requirement constrains independent NP practice formation in TN — solo cash-pay clinics, aesthetic NP practices, and direct-primary-care models are limited compared to FPA states. Vanderbilt University Medical Center is the largest TN academic-medical NP employer; Vanderbilt-Ingram Cancer Center is NCI-Designated Comprehensive (premium oncology NP specialty). St. Jude Children's Research Hospital (Memphis) is one of the top US pediatric cancer centers with substantial pediatric NP roles. HCA Healthcare HQ-Nashville operates ~50 TN hospitals with NP roles across ambulatory + inpatient + corporate clinical operations. Vanderbilt School of Nursing (top-10 US graduate program) is the primary in-state APRN pipeline. TN Board of Nursing licensure required.
Tennessee NP — 0% state, Vanderbilt premium, HCA corporate + telehealth, retirement-favorable
0%
TN state on wages + Hall repealed + 0% estate + 0% inheritance
RPA
TN reduced-practice-authority · physician collaborative agreement required · vs MA FPA
$185-265K
CRNA comp ceiling · Vanderbilt / HCA / Methodist / Erlanger + ASCs
$118-148K
Vanderbilt / HCA acute care NP · academic-medical premium · TN 0% state
Most NP roles are -exempt under the professional exemption — Vanderbilt / HCA / Methodist Le Bonheur / St. Jude / UT Medical / Erlanger staff NP positions are all exempt salaried. 's overtime deduction does not apply to standard NP comp. The TN market drivers: 0% state tax structure (vs MA's 5%, MD's 8%), Vanderbilt + HCA + St. Jude academic-medical premium, NLC + APRN-compact mobility for telehealth, CRNA $185-265K comp ceiling, density across non-profit hospitals.
TN's reduced-practice-authority is similar to MD + IN. NPs in TN must maintain a written collaborative practice agreement with a physician — physician oversight on prescribing protocols + chart review requirements. This constrains independent practice formation: solo cash-pay primary care clinics, aesthetic NP practices, and direct-primary-care models are difficult to operate in TN compared to MA / WA / AZ / CO (FPA states). The TN lever is corporate / hospital employment (Vanderbilt, HCA, St. Jude) plus telehealth across multi-state via NLC + APRN compact mobility — rather than solo-practice ownership.
Real numbers: a Vanderbilt acute care NP at $138K base — TN state tax = $0/year. Same comp in MD: $11,000/year combined. TN saves $11,000/year vs MD at staff NP tier. Same comp in MA: $6,900. TN saves $6,900/year vs MA. Same comp in IN (Hamilton): $5,660. TN saves $5,660/year vs IN. eligibility ($120-175K MSN / DNP federal balance forgiven after 10 years at Vanderbilt / Methodist Le Bonheur / St. Jude / UT Medical / Covenant) saves $80-150K in lifetime debt. The TN 0% state + Vanderbilt premium + PSLF + 0% retirement-state combination is among the most attractive US NP comp + lifetime structure of any state.
Tennessee for nurse practitioners — the honest take
TN NP practice clusters in three corridors. The Nashville / Williamson corridor (Vanderbilt University Medical Center, HCA Healthcare HQ + Nashville-area hospitals, Centerstone for PMHNP, Williamson Medical Center, Sumner Regional, Ascension Saint Thomas) is the densest US NP market by single-employer concentration outside Boston / NYC. The Memphis corridor (Methodist Le Bonheur, St. Jude Children's, Saint Francis, Regional One Health) anchors west TN with strong oncology + pediatric specialty. The Knoxville (UT Medical Center, Covenant Health) and Chattanooga (Erlanger) corridors anchor east TN. Plus statewide telehealth NP market via NLC + APRN compact mobility.
Vanderbilt's academic-medical premium drives the TN NP top tier. Vanderbilt staff NP comp ($118-148K depending on specialty) runs $10-30K above community-hospital comp at HCA-affiliated regional hospitals. Plus Vanderbilt's (501(c)(3) academic medical center) offering BOTH 403(b) and for combined $49,000/year pre-tax shelter — federal-only savings (TN 0% state) but still major active-duty lever. Williamson County housing $475-1.0M mid-tier and Brentwood / Franklin premium $625-1.2M. Davidson (East Nashville, Sylvan Park) at $325-625K. Memphis (Germantown, Collierville) at $400-700K.
Most TN NPs retire in-state — TN's 0% state + 0% estate + 0% inheritance + low 0.64% property tax is among the most favorable US NP retirement structures. Vanderbilt + accumulation + HCA + telehealth multi-state income retire well in TN structure. Common retirement patterns: stay in Williamson / Davidson / Sumner for grandkid proximity, or migrate to Smoky Mountains foothills (Sevier, Blount) or Cumberland Plateau for retirement lifestyle. The TN structure is among the most favorable US senior NP state-tax structures available.
How Tennessee taxes work for nurse practitioners (and where the levers are)
TN charges 0% state income tax — no wage tax. The Hall income tax (which historically taxed dividends and interest at 6%) was fully repealed effective 2021, so investment income is also 0% state. For a Vanderbilt acute care NP at $138K total: TN state tax = $0/year. Same comp in MA: $6,900/year. Same comp in MD: $11,000/year combined. Same comp in IN (Hamilton): $5,660/year combined. TN saves $5,660-11,000/year vs MA / MD / IN at the staff NP comp tier.
/ maxing is the central active-duty move. Vanderbilt as 501(c)(3) academic medical center offers BOTH 403(b) and for combined $49,000/year pre-tax shelter. Methodist Le Bonheur + St. Jude + UT Medical + Covenant + Erlanger all offer 403(b) at $24,500/year + match. HCA Healthcare offers 401(k) + ESPP (15% off) + RSU at corporate roles. At $138K TN NP + 22% federal marginal, maxing $24,500 saves $5,390/year federal (no state offset since TN is 0%).
for non-profit hospital NPs at Vanderbilt / Methodist Le Bonheur / St. Jude / UT Medical / Covenant Health / Erlanger Health — 10 years of qualifying federal student loan payments resulting in tax-free MSN / DNP debt forgiveness. For an NP with $120-175K MSN / DNP federal balance, 10 years at Vanderbilt or St. Jude erases the entire balance vs the typical 25-year self-pay. Lifetime savings $80-150K — a far bigger lever than the TN-vs-MA annual tax delta over a 10-year horizon.
Telehealth NP via NLC + APRN compact mobility is the unique TN active-duty lever. NLC compact full participation since 2003 + APRN compact (TN implementing as of 2024-2026) enables TN-resident NPs to provide telehealth services to patients in 40+ compact states. Tax treatment: telehealth income from TN-anchored employer remains TN 0% state; telehealth income from out-of-state employer may face source-state tax (varies by state telehealth rules). Annual income $115-165K typical for full-time telehealth NP based in TN.
- →TN 0% state on wages + 0% on investment income + 0% estate + 0% inheritance · saves $5-11K/year vs MA / MD / IN at NP comp tier
- →Vanderbilt Magnet + combined $49K/year federal pre-tax shelter (501(c)(3) academic medical center) · most generous TN NP retirement plan
- → on $120-175K MSN / DNP federal balance: 10 years at Vanderbilt / Methodist / St. Jude / UT Medical / Covenant / Erlanger = tax-free forgiveness · $80-150K lifetime savings
- →Telehealth NP via NLC + APRN compact: TN-anchored employer · serve multi-state · $115-165K · 0% TN residency tax
- →Pursue PMHNP specialty: $118-155K + Vanderbilt psych + Centerstone + telepsych private · TN telepsych rapidly expanding
- →St. Jude Children's pediatric NP specialty (Memphis): top US pediatric cancer center · NCI-Designated Comprehensive · $118-155K
- →Consider CRNA pathway: $185-265K comp ceiling at Vanderbilt / HCA / Methodist / Erlanger / ASCs · 27-month post-MSN training
- →Stay in TN for retirement: 0% state + 0% estate + 0% inheritance + low property tax · among most favorable US NP retirement structures
The Tennessee NP career arc — RN to specialty NP / CRNA / telehealth
Years 0-3 (post-MSN / DNP): $98-118K. RN background (BSN minimum, MSN required) + TN Board of Nursing APRN licensure + national certification (AANP, ANCC). Vanderbilt School of Nursing (top-10 US graduate program) + UT Health Science Center + ETSU + Belmont + Tennessee State + MTSU feed in-state pipeline. TN reduced-practice-authority requires written collaborative practice agreement with physician. Decision point: primary care (FNP, AGNP at $98-118K) vs acute care (ACNP, AGACNP at Vanderbilt / HCA $118-148K) vs psych (PMHNP $118-145K starting) vs anesthesia (CRNA pathway adds 27 months training, leads to $185-265K) vs telehealth multi-state (NLC + APRN compact mobility).
Years 3-10 (established practice + specialty): $115-185K depending on specialty. Vanderbilt acute NP $128-148K with academic-medical premium. PMHNP $128-185K with Vanderbilt psych + Centerstone + telepsych mix. CRNA $215-265K post-residency at Vanderbilt / HCA / Methodist / Erlanger / ASCs. St. Jude pediatric NP $128-155K. Aesthetic NP $155-225K at Williamson County / Germantown medspas with revenue share. Maxing + at Vanderbilt ($49K/year) is the peak active-duty lever.
Years 10+ (senior NP / leadership / retirement): $135-265K depending on track. Senior PMHNP with Vanderbilt + telepsych + private practice can reach $155-205K. CRNA seniority + leadership reaches $245-295K. St. Jude senior pediatric NP / clinical lead $145-185K. Telehealth NP serving multi-state $135-185K. Most TN NPs retire in-state — TN's 0% state + 0% estate + 0% inheritance is among the most favorable US NP retirement structures.
Where Tennessee NPs actually live
TN NP housing tracks employer + commute. Vanderbilt + HCA Nashville NPs in Williamson affordable (Spring Hill, Nolensville), Davidson (East Nashville, Sylvan Park), Sumner (Hendersonville), or Wilson (Mt. Juliet). Methodist Le Bonheur + St. Jude NPs in Shelby (Germantown, Collierville). UT Medical Knoxville NPs in Knox. Erlanger Chattanooga NPs in Hamilton. Telehealth NPs anywhere in TN (often choose Williamson / Sumner for top schools).
Spring Hill / Nolensville (Williamson affordable)
$375-625K · 0% state · Vanderbilt / HCA Nashville commute · top schools
Hendersonville (Sumner)
$375-625K · 0% state · Vanderbilt / Sumner Regional commute
Brentwood / Franklin (Williamson premium)
$625K-$1.2M · 0% state · top US schools · Vanderbilt commute
Germantown / Collierville (Shelby/Memphis)
$400-700K · 0% state · Methodist Le Bonheur + St. Jude
Farragut / West Knoxville (Knox)
$325-650K · 0% state · UT Medical Knoxville + Covenant Health
TN's Vanderbilt + HCA + St. Jude academic-medical premium + telehealth multi-state mobility (NLC + APRN compact) + 0% state + 0% estate retirement structure make TN among the most favorable US NP markets — strong active-duty + most-favorable retirement structure of any state. Reduced-practice-authority is the structural constraint vs MA's FPA, but corporate / hospital track + telehealth mitigates the limitation.
Is this the right move?
Tennessee NPs — who it's best for
Working in your favor
- +TN 0% state + 0% Hall + 0% estate + 0% inheritance · most favorable US NP tax structure
- +Vanderbilt University Medical Center: top-10 US nursing program + Magnet status + NCI-Designated Comprehensive Cancer Center · $118-148K acute NP
- +HCA Healthcare HQ-Nashville: largest US for-profit hospital chain · $108-128K + corporate-track NP roles
- +St. Jude Children's Research Hospital: top US pediatric cancer center + Magnet · $118-155K pediatric NP
- +NLC + APRN compact mobility: telehealth NP across 40+ compact states · $115-165K · 0% TN residency
Worth knowing before you sign
- −TN reduced-practice-authority: physician collaborative agreement required · constrains solo-practice formation vs MA / WA / AZ / CO FPA peers
- −TN base NP comp ($98-118K mid-career FNP) below MA / NY / CA · 0% state offsets but headline lower
- −Solo cash-pay clinics + aesthetic NP + direct-primary-care models difficult in TN vs FPA states
- −Vanderbilt + HCA both non-union · limited collective bargaining for NP staff
- −Sales tax 7% state + local (up to 9.75%) · highest combined US sales tax · partially offsets 0% income tax for high-spending households
Job Market in Tennessee
Tennessee has active demand for Nurse Practitioners.
Growth outlook: BLS projects 38% growth 2022-2032 — one of fastest-growing US occupations. Full Practice Authority states (24 states + DC as of 2026) drive uniquely high NP scope + independent practice opportunity. PMHNP shortage post-2020 mental health crisis = highest specialty premium ($145K-$220K). Aesthetic NP cash-pay 1099 path uniquely lucrative.
Related job titles:
Cost of Living in Tennessee
Tennessee has a varied cost of living by region.
💰 Monthly take-home: $8,059
🏠 Typical rent: $1,600/mo
📊 After rent: $6,459/mo
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