Healthcare Provider Details

I. General information

NPI: 1255289237
Provider Name (Legal Business Name): MARLEA KERR RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MARLEA KUDLAUSKAS

II. Dates (important events)

Enumeration Date: 03/17/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 27TH ST
LUMBERTON NC
28358-3075
US

IV. Provider business mailing address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

V. Phone/Fax

Practice location:
  • Phone: 910-671-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number395206
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: