Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shane Micheal Hardemon

Individual provider Peer Specialist · NPI 1003634478

Shane Micheal Hardemon is a Peer Specialist in Blackwell, Oklahoma. Practices as a sole proprietor. Licensed in Oklahoma.

Licensed in
OK
In the registry since
2024

Practice location Address checks out

444 E College Ave
Blackwell, OK 74631-3319
Phone: (580) 401-7527
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Peer Specialist (primary) Taxonomy 175T00000X (OK)

Record details

NPI number1003634478
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 2, 2024
Last updated in NPPESOctober 2, 2024
Certification dateOctober 2, 2024
Mailing address444 E College Ave, Blackwell, OK 74631-3319

Other providers in Blackwell