Healthcare Provider Details

I. General information

NPI: 1114844404
Provider Name (Legal Business Name): EMILY BETH PURCELL RN, BSN, OCN, MBA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1052 MARTIN LUTHER KING DR STE 2
CENTRALIA IL
62801-3002
US

IV. Provider business mailing address

1052 MARTIN LUTHER KING DR STE 2
CENTRALIA IL
62801-3002
US

V. Phone/Fax

Practice location:
  • Phone: 618-436-5410
  • Fax: 618-436-8063
Mailing address:
  • Phone: 618-436-5410
  • Fax: 618-436-8063

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number041337151
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: