I don't think this helps much, but looking at the image on nclandgrants.com I think the other name is "Niman Harrison" rather than "Ninian". Unfortunately nclandgrants doesn't have a grant for either name.
I'm guessing the "B.O." in "Oakes Branch to B.O." refers to a bearing object, which is:
"BEARING OBJECT – (PLSS)- A corner accessory which may be a natural object that can be readily identified by its distance and direction from the corner being recorded."
So, some mark or other that was semi-permanent? I'm not a surveyor. I think it could just be a mark in a tree.
Nclandgrants has another entry for Oakes Branch: John Oakes for 100 acres "On Oakes branch a water of Moons Creek"
Sounds like that's the origin of the creek name. Unfortunately the patent doc doesn't offer any more clues, except that it's next to Samuel Paul's land, which we knew already. The survey docs might help if they're available.
Also note there are two branches to Moon Creek - between them they cover a lot of area.