=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659236594
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IOWA QUICKCARE
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/23/2025
-----------------------------------------------------
Last Update Date | 12/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 601 N THOMSON AVE STE C SUITE C
-----------------------------------------------------
City | IOWA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70647-7000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-409-8081
-----------------------------------------------------
Fax | 337-270-5375
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 601 N THOMSON AVE STE C
-----------------------------------------------------
City | IOWA
-----------------------------------------------------
State | LA
-----------------------------------------------------
Zip | 70647-7000
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 337-409-8081
-----------------------------------------------------
Fax | 337-270-5375
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER, PROVIDER
-----------------------------------------------------
Name | MRS. MADISON RILEY BOURQUE
-----------------------------------------------------
Credential | MSN, APRN, FNP-C
-----------------------------------------------------
Telephone | 706-662-5340
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------