Financial Advisor for CRNAs in Nashville, TN
Tennessee’s zero state income tax is a genuine advantage for CRNAs, but only if your financial plan is built to capture it. We help nurse anesthetists in Nashville reduce their federal tax burden, build a clear retirement strategy, and turn high income into lasting financial independence.
Financial Advisor, 2025
No commissions. Ever.
Brett Fellows, 20+ Years
You've Earned This
Nashville CRNAs Have a Real Tax Advantage. Most Aren't Maximizing It.
CRNAs in the Nashville area earn between $190,000 and $225,000 a year on average. With major systems like Vanderbilt, HCA, and TriStar driving demand for anesthesia services, the earning opportunity here is strong. And because Tennessee has no state income tax, CRNAs in Nashville keep more of every dollar they earn than peers in most other states.
But that advantage is only meaningful if your overall financial plan is structured to build on it. Federal taxes still take a large share of a CRNA’s income. Your retirement accounts are likely loaded with pre-tax dollars that will be taxed heavily when you withdraw them. If you’re doing locum work alongside a staff position, two different tax rules apply and most advisors can handle only one of them well. Even with strong earnings, a lot of CRNAs reach their 50s not entirely sure whether they’ve built enough to actually stop.
Oak Capital Advisors specializes in financial planning for CRNAs. We understand the account structures, the income patterns, and the career arc that comes with anesthesia work, and we design plans around all of it.
“Tennessee has no state income tax. How do I actually take advantage of that in my planning?””My 403(b) is large and growing. I’m worried about the tax bill when I start pulling from it.””I want to retire before 60. Is that realistic based on where I am now?””Is there a financial advisor who already knows what a CRNA’s finances look like, so I’m not starting from zero?”
If those questions resonate, you’ve found the right place.
What We See Every Day
The Financial Challenges Nashville CRNAs Face
The problems that show up most often in our work with CRNAs aren’t random. They’re structural, built into how anesthesia careers are compensated and how most retirement savings vehicles are designed. Unaddressed, they carry a real cost.
The Federal Tax Bill Hiding in Your 403(b)
Tennessee’s lack of state income tax is a genuine perk, but it doesn’t change what the federal government will collect from your 403(b) or 457(b) when you start withdrawing. Every dollar comes out as ordinary income. Required minimum distributions can force large withdrawals whether you need the money or not, potentially pushing you back into the top brackets during a period of life when you expected your tax rate to fall.
Burnout and the Early Exit Question
Nashville’s healthcare market is busy, and the physical and mental toll of anesthesia adds up. A lot of the CRNAs we talk with have been thinking about retiring earlier than they originally planned, but they aren’t sure their savings support it. We help answer that question with actual numbers, not estimates.
IRMAA: The Medicare Surcharge Few CRNAs Expect
Medicare premiums aren’t flat for high earners. IRMAA surcharges add hundreds per month based on your income from two years prior. For CRNAs who earn well through their final working years, this surcharge can increase healthcare costs in early retirement. Getting ahead of it through income planning and Roth conversions reduces the impact.
W-2 and 1099 Income: Two Rulesets, One Tax Return
The Nashville healthcare market offers abundant locum opportunities alongside staff positions at major hospital systems. Managing both income streams requires coordinating retirement contribution limits, handling self-employment tax, and identifying deductions that apply to independent work but not to W-2 income. It’s a planning situation most generalist advisors handle inconsistently at best.
No Distribution Strategy for Retirement
The accumulation phase and the distribution phase of retirement require very different thinking. Choosing which accounts to draw from first, and in what proportions, directly affects how much of your savings you’ll actually keep versus what goes to taxes. Without a thoughtful withdrawal sequence, the default can be surprisingly costly.
Getting the Most Out of Social Security as a High Earner
CRNAs with strong earnings histories have sizable Social Security benefits, and real potential value in getting the claiming decision right. The timing strategy depends on your health, your spouse’s benefit, your other retirement income sources, and your tax situation. This isn’t a decision to make casually.
What We Do Together
Financial Planning That Fits a CRNA's Career and Goals
Every CRNA we work with has a different mix of accounts, timelines, and priorities. We don’t use a template. We build around your specifics.
Tax Planning
We stay engaged with your tax situation year-round, not just during tax season. Ongoing visibility is what allows us to identify and act on opportunities before they close.
Roth Conversion Strategy
We calculate the right years and amounts to shift pre-tax dollars into Roth, reducing your lifetime tax exposure and establishing a tax-free pool of assets for retirement income.
Retirement Income Planning
We design a sequenced withdrawal strategy, spanning your taxable, tax-deferred, and Roth accounts, that generates the income you need while keeping your tax burden as low as possible over the long run.
Investment Management
Evidence-based portfolios built to match your goals, time horizon, and risk tolerance. No speculation, no products selected for commission, no market-timing strategies.
Social Security Optimization
We model your Social Security options in detail, including spousal benefits and how timing interacts with your other income sources, so you can make this decision with clarity rather than guesswork.
Estate and Legacy Planning
We coordinate with your estate attorney to ensure your assets are titled and structured to move to your intended beneficiaries with the least possible friction from taxes or legal delays.
How It Works
Getting Started Is Simpler Than You Think
We don’t believe in pressure. We believe in fit. Our process is designed to give you a clear picture of how we can help before you make any commitment
1
Schedule Your Introductory Call
Think of it like your Pre-Op Assessment. Share your plans and your current challenges. We’ll talk about our process and see if we’re a good fit for working together.
You’ll see, at a high level, how our firm can improve your finances and help you build, grow, and preserve your wealth. To learn more about what to expect, check out our full discovery process.
2
Take a Time-Out
We’re looking for a long-term relationship, not a quick transaction. After your call, take the time you need to decide if working together makes sense. If we aren’t the right fit, we’ll do our best to point you toward someone who is.
3
Induction of Ongoing Advice
Once you decide to move forward, we get to work. We gather a full picture of your finances, build your personalized plan, and become your ongoing financial partner. You delegate the complexity. We handle it.
Why Oak Capital Advisors
The Financial Advisor Nashville CRNAs Have Been Looking For
Most financial advisors serve everyone. We’ve built our practice around the specific financial planning needs of nurses and advanced practice providers. That focus changes the quality of advice you receive.
CRNA Financial Planning Is Our Core Focus
We’ve spent years working through the specific planning challenges that come with a career in anesthesia. 403(b) issues, locum income coordination, early retirement modeling, IRMAA planning. This is our area of expertise, not a specialty we bolted on.
Fee-Only and Fiduciary
We are compensated solely by our clients. We sell no financial products and earn no commissions. As a fiduciary, we are legally required to act in your best interest, not just recommend what’s ‘suitable.’
Wealthtender Voice of the Client™ Award
In 2025, Brett Fellows was named a Wealthtender Highly Rated Advisor, recognizing advisors who consistently earn superior client reviews with an average rating of 4.75 or higher.
Serving Nashville CRNAs Remotely, Without Sacrificing Quality
Our office is in Mt. Pleasant, SC. We work with CRNAs across Tennessee and the country via phone and Zoom. Our virtual process is designed to be as thorough and responsive as any in-person relationship
Two Decades of Real-World Planning Experience
Brett Fellows has been a practicing financial planner since 2005. He’s handled major market downturns, sweeping tax law changes, and dozens of retirement transitions, many of which look a lot like yours.
CFP® Certified
The CERTIFIED FINANCIAL PLANNER™ designation is the most respected credential in personal financial planning. Fewer than 1 in 4 advisors hold it. Brett is one of them.
Common Questions
What CRNAs in Nashville Ask Us Most
It changes one part of the equation, the state tax piece, but the federal picture remains just as complex and, at a CRNA’s income level, just as important. The absence of state income tax makes Tennessee a particularly efficient state to earn in, but it doesn’t reduce the pre-tax liability in your 403(b) or change how required minimum distributions work. Federal planning, especially Roth conversion strategy, is still central to making the most of what you’ve saved.
Start with a full picture of what you have, when you plan to retire, and what your income will look like in retirement. From there, the key question is: how much of your pre-tax balance can you convert to Roth each year before Social Security and required minimum distributions arrive and fill up your lower tax brackets? That conversion window, typically between retirement and age 73, is where most of the planning value lives. We model this for every client we work with.
1099 income opens the door to a Solo 401(k), which has its own contribution limits separate from your hospital plan. That can increase the amount you’re sheltering from taxes each year. But there are coordination rules between the two plans, and the self-employment tax on 1099 income adds another layer to the analysis. We work through both income streams together, not in isolation.
A commission-based advisor gets paid when they sell you financial products, and the products that pay the most commission aren’t always the best ones for your situation. A fee-only advisor is paid directly by you, without any compensation tied to what they recommend. As a fiduciary, we have a legal obligation to recommend what’s in your best interest. The distinction matters most when the stakes are high, which describes most of the decisions CRNAs are making.
We help CRNAs answer exactly this question. We build a retirement readiness analysis that models your assets, expected expenses, healthcare costs including IRMAA, Social Security timing, and income sequencing. After that work, you’ll have a clear view of whether you’re there now, what you need to get there in a defined timeframe, or what trade-offs you’d need to make to move the date closer.
Yes. We serve CRNAs in Tennessee and across the country via phone and Zoom. Our virtual process is built for exactly this kind of relationship.
You've built the income. Now let's build the plan.
Start with a free 30-minute call. We’ll talk through your situation, walk you through how we work with CRNAs, and give you a clear sense of whether we’re a fit. No obligation. No pressure.
Oak Capital Advisors
126 Seven Farms Drive Suite 160
Charleston, SC 29492 • (843) 284-0798
© 2024 Oak Capital Advisors, LLC. All rights reserved.