Healthcare Provider Details

I. General information

NPI: 1407700255
Provider Name (Legal Business Name): EBONY TANSIEL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/26/2026
Last Update Date: 02/26/2026
Certification Date: 02/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8845 WINDLAKE DR
DENHAM SPRINGS LA
70726-6763
US

IV. Provider business mailing address

8845 WINDLAKE DR
DENHAM SPRINGS LA
70726-6763
US

V. Phone/Fax

Practice location:
  • Phone: 225-610-0174
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347E00000X
TaxonomyTransportation Broker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: