Healthcare Provider Details

I. General information

NPI: 1679418610
Provider Name (Legal Business Name): EVOLVE WELLNESS NURSING APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/23/2026
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1582 W SAN MARCOS BLVD STE 100
SAN MARCOS CA
92078-4081
US

IV. Provider business mailing address

1582 W SAN MARCOS BLVD STE 100
SAN MARCOS CA
92078-4081
US

V. Phone/Fax

Practice location:
  • Phone: 442-222-1303
  • Fax: 858-400-8332
Mailing address:
  • Phone: 442-222-1514
  • Fax: 858-400-8332

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: LYNETTE EASLER-SILVA
Title or Position: CEO
Credential: NP
Phone: 442-222-1514