Healthcare Provider Details

I. General information

NPI: 1265324958
Provider Name (Legal Business Name): ABBIGAIL JONES MATHIEU FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

605 W GOVERNMENT ST
BRANDON MS
39042-3153
US

IV. Provider business mailing address

PO BOX 1465
BRANDON MS
39043-1465
US

V. Phone/Fax

Practice location:
  • Phone: 601-825-2696
  • Fax: 601-825-2463
Mailing address:
  • Phone: 601-825-2696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number907564
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: