Sheriff Keith Stone said a family member who reported Sarah Denise Patterson missing, told investigators it was out of character for the certified nursing assistant to not show up for work over the weekend.
Stone did not say where Patterson, of Pinewoods Drive in Raleigh, works.
She was last seen Thursday evening at a relative's home in the 4200 block of Biltmore Lane in Spring Hope.
The 51-year-old with no history of mental health issues, was last seen driving a 2010 burgundy Honda Accord, license plate number FBK-8456.
"That's what's so suspicious about it," said Stone. "There's no concrete evidence of where she was going or who she was with. That's what's puzzling at this time."
ABC11 was at the home on Biltmore Lane on Tuesday afternoon where investigators were seen talking with a man who pulled into the driveway.
Stone said they have no persons of interest at this time.
"I cannot even begin to speculate," Stone said on Patterson's whereabouts. "I can only imagine the thought process of the family members that they've not seen their loved one since the weekend and now we're at Tuesday. We're doing everything we can to try to bring resolve to this."
Patterson is described as 5'4" and about 180 pounds, with brown eyes, short brown hair, and known to wear prescription glasses.
Anyone with information should call the Nash County Sheriff's Office at (252) 459-1510, or Crimestoppers at (252) 977-1111.