Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Sandra Rae Divine, PTA

Individual provider Skilled Nursing Facility · NPI 1932507431

Sandra Rae Divine, PTA is a Skilled Nursing Facility in Stockton, Missouri. Practices as a sole proprietor. Licensed in Missouri.

Licensed in
MO
In the registry since
2014
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1015 Lancaster Dr
Stockton, MO 65785-8360
Phone: (417) 276-4531
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Skilled Nursing Facility (primary) Taxonomy 314000000X · Licence 115167 (MO)

Record details

NPI number1932507431
Entity typeIndividual (Type 1)
GenderFemale
Credentials PTA
Sole proprietorYes
NPI enumeratedDecember 15, 2014
Last updated in NPPESDecember 15, 2014

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