Individual
KETTIA NEPHTALIE GUILLITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 S LAKE ST, FARMINGTON, NM 87401-5619
(505) 278-8575
Mailing address
301 S LAKE ST, FARMINGTON, NM 87401-5619
(505) 278-8575
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
323904
NY
207RN0300X
Nephrology Physician
Primary
MD2025-0787
NM
Other
Enumeration date
04/08/2020
Last updated
09/10/2025
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