Individual ProviderSunny ProvenceNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice AddressWomack Army Medical Center, Fort Bragg, NC 28310-5000(910) 907-8922PECOS EnrollmentBased on the most recent information from CMS, provider Sunny Provence is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1710394226Provider TypeIndividualFull NameProvence, SunnyCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date7/16/2014Last Updated10/20/2025Contact InformationPractice LocationPractice AddressWomack Army Medical Center, Fort Bragg, NC 28310-5000Phone(910) 907-8922Fax(910) 907-6069Mailing LocationMailing Address2817 Rock Merrit Ave, Fort Bragg, NC 28310-0001Phone(910) 907-8922Fax(910) 907-6069Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAP125791Texas