Provider Demographics
NPI:1093466062
Name:LEGER, VICTORIA ANNE (CRNA)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ANNE
Last Name:LEGER
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ANNE
Other - Last Name:BERTRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2263 GLENDALE AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-2841
Mailing Address - Country:US
Mailing Address - Phone:225-610-4446
Mailing Address - Fax:
Practice Address - Street 1:8080 BLUEBONNET BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-7827
Practice Address - Country:US
Practice Address - Phone:225-408-8080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-12
Last Update Date:2024-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1063618367500000X
LA234826367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered