Active NPI
Malissa Jean Driver
- Ambulatory Care Registered Nurse
- Omaha, NE
National Provider Identifier
1104763358
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ambulatory Care Registered Nurse
- License
- 123867
- Practice address
- 4101 Woolworth Ave
Omaha, NE 68105-1850 - Phone
- (402) 995-6913
- Fax
- (402) 930-7975
- NPI assigned
- May 4, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ambulatory Care Registered Nurse | 163WP2201X | 123867 | IA | Primary |
Addresses
Primary practice location
4101 Woolworth Ave
Omaha, NE 68105-1850
Mailing address
4101 Woolworth Ave
Omaha, NE 68105-1850
Phone (402) 995-6913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123867 | IA | MD | Ambulatory Care Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1777852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777852800000",
"number": "1104763358",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-995-6913",
"fax_number": "402-930-7975"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-995-6913",
"fax_number": "402-930-7975"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DRIVER",
"first_name": "MALISSA",
"middle_name": "JEAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2026-05-04",
"last_updated": "2026-05-04",
"certification_date": "2026-05-04",
"status": "A"
},
"taxonomies": [
{
"code": "163WP2201X",
"taxonomy_group": "",
"desc": "Registered Nurse, Ambulatory Care",
"state": "IA",
"license": "123867",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.