Healthcare Provider Details

I. General information

NPI: 1275412744
Provider Name (Legal Business Name): MICHAEL LESPRON DNP, APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/29/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

727 S WAHANNA RD STE 220
SEASIDE OR
97138-7735
US

IV. Provider business mailing address

11042 N 17TH DR
PHOENIX AZ
85029-3708
US

V. Phone/Fax

Practice location:
  • Phone: 503-717-7060
  • Fax:
Mailing address:
  • Phone: 602-819-0830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number248339
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: