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General NPI Number Information
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NPI Number | 1073173258
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Entity Type | Individual
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Provider Name | JINA LIBBY DO
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Gender | Female
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Dates
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Enumeration Date | 06/19/2019
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 143 HOSPITAL DRIVE
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City | STATE COLLEGE
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State | PA
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Zip | 16803-6706
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Country | US
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Telephone | 814-865-3566
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Fax | 142-354-7808
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Provider Business Mailing Address
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Address Line | 143 HOSPITAL DRIVE
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City | STATE COLLEGE
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State | PA
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Zip | 16803
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Country | US
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Telephone | 610-208-4648
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5151013974
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number | OS024239
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | OS024239
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License Number State | PA
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