Provider Demographics
NPI:1881718724
Name:GURKSNIS, LOUISE ANN (OTR)
Entity type:Individual
Prefix:MS
First Name:LOUISE
Middle Name:ANN
Last Name:GURKSNIS
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 DOYLE CT
Mailing Address - Street 2:
Mailing Address - City:FITZWILLIAM
Mailing Address - State:NH
Mailing Address - Zip Code:03447-3284
Mailing Address - Country:US
Mailing Address - Phone:603-762-2001
Mailing Address - Fax:
Practice Address - Street 1:18 DOYLE CT
Practice Address - Street 2:
Practice Address - City:FITZWILLIAM
Practice Address - State:NH
Practice Address - Zip Code:03447-3284
Practice Address - Country:US
Practice Address - Phone:603-762-2001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-17
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOTA264224Z00000X
NH2036225X00000X
FLOT 13161225X00000X
MA9731225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
No224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant