Individual
ELISSA CLAIR GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1665 WESTBROOK PLAZA DR, WINSTON SALEM, NC 27103-2993
(336) 760-8380
Mailing address
100 KIMEL FOREST DR, WINSTON SALEM, NC 27103-6074
(336) 716-1331
(336) 716-3202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-08976
NC
363A00000X
Physician Assistant
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-08976
NORTH CAROLINA MEDICAL BOARD
NC
Enumeration date
04/05/2019
Last updated
04/21/2026
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