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Individual

CIERA RAE DENOVELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
6 WELLNESS WAY STE 108, LATHAM, NY 12110-2142
(518) 370-7937
(518) 377-2983
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
352333
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
07899952
NY
Enumeration date
09/26/2023
Last updated
05/05/2026
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