Healthcare Provider Details

I. General information

NPI: 1639059512
Provider Name (Legal Business Name): ON POINT MOBILE MED, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2025
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3398 W SELTICE WAY UNIT 305
COEUR D ALENE ID
83814-6314
US

IV. Provider business mailing address

3398 W SELTICE WAY UNIT 305
COEUR D ALENE ID
83814-6314
US

V. Phone/Fax

Practice location:
  • Phone: 208-826-1054
  • Fax:
Mailing address:
  • Phone: 208-826-1054
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CHRISTINE LYNN EVANS
Title or Position: OWNER
Credential: NP
Phone: 208-826-1054