Courtney Nicolle Forman
PMHNP-BC, FNP-C, FPA | Nurse Practitioner - Psych/Mental Health | 15+ years Exp
2823 Glenwood Ave, Rockford
Illinois, 61101
815-968-5342
Courtney Nicolle Forman is a Rockford, Illinois based nurse practitioner with 15 years of experience as Psych/Mental Health NP. She completed her graduation from Indiana University School Of Medicine in 2011. She accepts the Medicare-approved amount. Patients will not be billed for any more than the Medicare deductible and coinsurance. Active license number of Courtney Nicolle Forman is 227.004073 for Nurse Practitioner in Illinois. Her current practice location is 2823 Glenwood Ave, Rockford. Patients can reach her at 815-968-5342 or can fax her at 815-968-4656. Courtney Nicolle Forman is PMHNP-BC, FNP-C, FPA with specialization in Psych/Mental Health NP and her NPI number (Unique professional ID assigned by NPPES) is 1376099127.
Courtney Nicolle Forman provides a full range of primary mental health care services, including biopsychosocial assessment and diagnosis of patients with mental illness and co-occurring disorders. Treatment modalities include both medication and psychotherapeutic management. Psych/Mental Health Nurse Practitioner (PMHNP) works in a variety of settings, including inpatient, emergency and community-based mental health services.
Complete Profile:
Courtney Nicolle Forman speciality, credentials, practice address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointment.
| Name: | Courtney Nicolle Forman |
| Specialization: | Nurse Practitioner - Psych/Mental Health (PMHNP) |
| Gender: | Female |
| Credentials: | PMHNP-BC, FNP-C, FPA |
| Experience: | 15+ years |
| Medical School Attended: | Indiana University School Of Medicine |
| Graduation Year: | 2011 |
| Accepts Medicare Assignment: | Yes |
| Practice Address: | 2823 Glenwood Ave, Rockford,
Illinois, 61101 |
| Phone: | 815-968-5342 |
| Fax: | 815-968-4656 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| PAC ID: | 0042507220 |
| Enrollment ID: | I20161003001862 |
| NPI Number: | 1376099127 |
| NPI Enumeration Date: | 31 Aug, 2016 |
| NPI Last Update On: | 30 Mar, 2026 |
Medical Licenses:
NPs can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Courtney Nicolle Forman are as mentioned below.
| License Number | Specialization | State | Status | |
| 227.004073 | Nurse Practitioner | Illinois | Primary | |
| 277004073 | Psych/Mental Health NP | Illinois | Secondary | |
| 209014910 | Family NP | Illinois | Secondary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Courtney Nicolle Forman
7080 Mill Rd,
Rockford, Illinois |
| Zip: | 61108-2623 |
| Phone Number: | 815-209-8486 |
Patients can reach Courtney Nicolle Forman at
2823 Glenwood Ave, Rockford, Illinois or can
call to book an appointment on 815-968-5342.
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Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 June, 2026.