# SANA KASUMOVIC PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1295680809
- **Authorized official:** SANDRA KASUMOVIC DMSC, MPAS (PA-C)
- **Authorized official phone:** (208) 850-5111

## Contact information

- **Practice address:** 2716 SYRINGA LN, CALDWELL, ID 83605-3052
- **Practice address phone:** (208) 850-5111
- **Mailing address:** 2716 SYRINGA LN, CALDWELL, ID 83605-3052
- **Mailing address phone:** (208) 477-1223

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | Yes |
| 363A00000X | Physician Assistant | — | — | Yes |
| 363AM0700X | Medical Physician Assistant | — | — | — |

## Other

- **Enumeration date:** 02/27/2026
- **Last updated:** 09/01/2026