Provider Demographics
NPI:1962380980
Name:VILLALOBOS, MILTON ARMANDO (FNP-C)
Entity type:Individual
Prefix:
First Name:MILTON
Middle Name:ARMANDO
Last Name:VILLALOBOS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 LANCASTER DR NE STE 104
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-1040
Mailing Address - Country:US
Mailing Address - Phone:971-273-0679
Mailing Address - Fax:503-961-0794
Practice Address - Street 1:1880 LANCASTER DR NE STE 104
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-1040
Practice Address - Country:US
Practice Address - Phone:971-273-0679
Practice Address - Fax:503-961-0794
Is Sole Proprietor?:No
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10047425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily